妇科腹腔镜与剖腹手术对机体凝血系统影响的研究

Comparative Analysis of Laparoscopic Surgery and Laparotomy Forcoagulation System in Patients

目的研究腹腔镜手术和剖腹手术对机体凝血系统的影响。方法对60例需行妇科手术的患者分成两组腹腔镜手术组30例(N1组)和剖腹手术组30例(N2组),检测60例患者术前、术后24 h及48 h静脉血清的D二聚体(D-D)、抗凝血酶(AT)凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)及纤维蛋白原(Fbg)水平,并对两组结果进行比较分析。结果两组术后24 h及48 h D-D和Fbg明显升高,AT、PT及aPTT显著降低(P<0.05),N1组和N2组组间PT、aPTT和Fbg有显著性差异(P<0.05),而D-D和AT差别无统计学意义(P>0.05)。结论腹腔镜手术和剖腹手术均使患者机体处于高凝状态,且腹腔镜手术后患者更易发生血栓性疾病。

Objective To study the effects of laparoscopic surgery and laparotomy on the body＇s blood coagulation system. Methods Sixty patients were divided into the laparoscopic surgery（ N1 group） and laparotomy（ N2 group） groups with 30 patients in each group. The levels of D-dimer（ D-D）,antithrombin（ AT）,prothrombin time（ PT）,activated partial clotting enzyme live time（ aPTT） and fibrinogen（ Fbg） in venous serum were detected preoperative and postoperative 24 and 48 hours in 60 cases of patients,and the two sets of results were compared. Results D-D and Fbg levels were obviously increased,while the AT、PT and aPTT levels were significantly reduced（ P〈0. 05） postoperative 24 hours and 48 hours in two groups. Significant differences of PT,aPTT and Fbg（ P〈0. 05） and no significant differences of D-D and AT（ P〈0. 05） were observed between N1 and N2 groups. Conclusion Both laparoscopic surgery and laparotomy may cause the patient body in high coagulation state,while the patients after laparoscopic surgery were more likely to occur thrombotic diseases.