腹腔镜胆囊切除高龄患者血液流变性变化的研究

Study on the changes of hemorheology in elder patients with laparoscopic cholecystectomy

目的 :探讨腹腔镜胆囊切除术对高龄患者血液流变性的影响 ,进一步认识腹腔镜胆囊切除术的特点。方法 :对 4 0名腹腔胆囊切除术高龄患者气腹前、气腹中、气腹后和术后第一天的全血粘度 (ηb)、血浆粘度 (ηP)、红细胞聚集指数 (EAI)、血沉方程K值 (ESRK)、血球压积 (HCT)和纤维蛋白原 (Fib)进行了检测比较和分析。结果 :高龄患者气腹后患者血液流变性和检测指标有明显的变化 ,气腹消除后未明显缓解 (P <0 .0 5 )。术后第一天 ,变化的指标恢复到气腹前水平 (P >0 .0 5 )。结论 :在一定控制范围内的气腹对腹腔镜胆囊切除高龄患者的血液动力学方面虽未引起明显的变化 ,但对血液流变性产生了影响 。

Objective To study the influence of laparoscopic cholecystectomy on hemorheology in patients with sallstone.Methods Whole blood viscosity (ηb),plasma viscosity(ηP),erythrocyte aggregation index (EAI), haematocrit (HCT), fibrinogen (Fib) and ESRK were assayed before pneumoperitoneum, during pneumoperiteneum, after pneumpoperitoneum and the first day of postoperation in 40 elder patients with laparoscopic cholecystectomy.Results The index of hemorheology had significant changes in the patients during pneumoperitoneum, and hadn't remitted immediately after pneumoperitoneum ( P <0.05). The concentration of hemorheology parameters in first day of postoperation recovered to that of before pneumoperitonium ( P >0.05).Conclusions Pneumoperitoneum in controlled range has no obvious influence of hemodynamic parameters in the patients, but has significant influence on hemorheology of the patients, which still lasts some time after peneumoperitoneum.Elder patients have more obvious changes of hemorheology.