后腹腔镜手术对深静脉血栓形成的影响

Effects of retroperitoneal laparoscopic on thrombosis

目的 探讨后腹腔镜下手术深静脉血栓形成的高危因素.方法 将40例行腹膜后手术患者分为2组,后腹腔镜组及开放手术组各20例,分别于术前及手术结束后抽取静脉血检测血小板数量（PLT）、血小板分布宽度（PDW）、平均血小板体积（MPV）、血栓调节蛋白（TM）及D-二聚体,比较分析2组上述指标的变化差异.结果 开放手术组及后腹腔镜组术前PLT、PDW、MPV、TM、D-二聚体分别为（177.0±61.0）与（186.6±38.1）×109/L、（12.5±2.6）与（13.4±3.1）V/fl、（10.7±1.2）与（11.1±1.4）V/fl、（22.3±9.0）与（24.7±7.6）ng/ml、（0.1±0.0）与（0.1±0.0）μg/ml,术后分别为（171.0±41.2）与（164.8±45.5）×109/L、（12.6±2.8）与（13.7±2.7）V/fl、（10.8±1.1）与（11.1±1.2）V/fl、（22.2±6.5）与（25.0±7.1）ng/m1、（0.2±0.2）与（0.1±0.1）μg/ml,2组手术前后比较差异均无统计学意义（P＞0.05）.结果 与开放手术相比,泌尿外科后腹腔镜手术对患者血小板参数、D-二聚体及血栓调节蛋白的影响较小.

Objective To investigate the effect of reptroperitoneal laparoscopic operation on the parameters of platelet, D-dimer and thrombomodulin（TM）. Methods Forty cases were divided into two groups according to the operative way, retroperitoneal laparoscopic operation （n= 20） and open operation （n=20）. Blood samples were taken preoperatively and at the end of the surgery. The following parameters were measured and compared within each group and between groups： platelet count （PLT）, mean platelet volume （MPV）, platelet distributionwidth（PDW）, D-dimer, TM. ResultsThere were no significant differences for the PLT, PDW, MPV, TM and D-dimer between before and after operation in each group. There was no difference between 2 groups either for all these indicators.No patients from either group suffered thrombosis or abnormal bleeding as a pastoperative complication. Conclusion Compared with the conventional operation, retroperitoneal laparoscopic operation dioesd not induce more change on parameters of platelet, D-dimer and TM.