卵巢囊肿围术期血浆D-二聚体、P-选择素、血管性血友病性因子的变化

Changes of D-dimer, P-selectin and von willebrand factor in ovarian cysts perioperative

目的探讨卵巢囊肿围术期血浆D-二聚体、P-选择素、血管性血友病性因子（VwF）变化，为预防腹腔镜手术后静脉栓塞性并发症提供依据。方法选择确诊为卵巢囊肿需行手术治疗的患者60例，根据患者的意愿分为腹腔镜组（39例）和开腹组（21例），所有患者术前、气腹解除后即手术结束后10min、术后24h分别测定血浆D-二聚体、P-选择素及VwF浓度，研究妇科腹腔镜手术前后患者血液凝固性的改变的情况，以及比较腹腔镜和开腹手术对患者血液凝固性的影响。结果腹腔镜组气腹解除后10min及术后24h血浆D-二聚体、P-选择素及VwF浓度均高于术前水平（P〈0．05）；开腹组手术结束后10min血浆D-二聚体、P-选择素及VwF浓度均高于术前水平（P〈0．05），但术后24h两者比较差异无统计学意义（P〉0．05）。结论腹腔镜组术后的血浆D-二聚体、P-选择素及VwF浓度均高于开腹组，术后24h腹腔镜组下降稍快于开腹组，提示腹腔镜手术并不增加血栓性疾病的发生率。

Objective To investigate the ovarian cysts perioperative on D-dimer, P-selectin, yon Willebrand factor changes, provide the basis for the prevention venous thromboembolie complications after laparoscopic surgery. Methods Sixty cases of ovarian cysts need surgical treatment were divided into the laparoscopy group （n =39） and laparotomy group（ n = 21 ） according to their wishes. All patients to check the D-dimer, P-selectin and VWF concentration before surgery, 10 rain after surgery, postoperative 24 hours. Study the blood coagulation before and after the gynecological laparoscopic surgery, and to compare laparoscopic and open surgery on the patients＇ blood coagulation. Results Laparoscopic group after 10 rain and 24 h after surgery, plasma D-dimer, P-selectin and VWF concentrations were higher than preoperative levels, the changes were significant differences （ P 〈 0. 05 ） ; Ten minutes after the end of the surgery, plasma D-dimer, P-factors and VWF concentrations in laparotomy group were higher than preoperative levels （P 〈 0.05）, but after 24 h, the difference was not statistically significant. Conclusions Postoperative plasma D-dimer, P-factors and VWF concentration in the laparoscopic group were higher than those in the laparotomy group, laparoscopic group decreased slightly faster than the laparotomy group after 24 h, suggesting that laparoscopic surgery does not increase the thrombosisthe incidence of disease.