腹腔镜手术与传统开腹手术对胃肠肿瘤患者的临床疗效及血凝状态观察

Clinical efficacy and blood coagulation status observation of laparoscopic surgery and traditional laparotomy for gastrointestinal neoplasms patients

目的对比分析腹腔镜手术与传统开腹手术治疗胃肠肿瘤的临床疗效及对患者血凝状态的影响。方法 154例胃肠肿瘤患者,随机分为观察组和对照组,每组77例。对照组采用传统开腹手术进行治疗,观察组采用腹腔镜手术进行治疗。对比两组患者的临床效果、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)指标等。结果观察组手术时间短于对照组、术中出血量少于对照组、排气时间短于对照组,并发症发生率低于对照组,差异均具有统计学意义(t=21.442、43.149、35.864,χ~2=9.606,P<0.05)。术前,两组患者的PT、APTT对比,差异均无统计学意义(P>0.05);术后24 h,两组患者的PT均较本组术前降低,且观察组降低程度优于对照组,差异均具有统计学意义(P<0.05);术后24 h,两组患者的APTT均较本组术前降低,且观察组降低程度优于对照组,但差异均无统计学意义(P>0.05)。结论对于胃肠肿瘤患者,采用腹腔镜手术在创伤性及并发症方面优于开腹手术,但在血凝方面,两种治疗方法均出现高凝状态,且腹腔镜方法较为明显;在临床实践中应根据患者的身体状态选择合适的治疗方法。

Objective To compare and analyze the clinical efficacy of laparoscopic surgery and traditional laparotomy for gastrointestinal neoplasms patients, and its influence on blood coagulation status. Methods A total of 154 gastrointestinal neoplasms patients were randomly divided into observation group and control group, with 77 cases in each group. The control group was treated with traditional laparotomy, and the observation group was treated with laparoscopic surgery. Comparison were made on clinical effect, activated partial thromboplastin time（APTT） and prothrombin time（PT） in two groups. Results The observation grouphad shorter operation time than the control group, less intraoperative bleeding volume than the control group, shorter exhaust time than the control group and lower incidence of complications than the control group. Their difference was statistically significant（t=21.442, 43.149, 35.864, χ~2=9.606, P〈0.05）. Before operation, both groups had no statistically significant difference in PT and APTT（P〉0.05）. In postperative 24 h, both groups had lower PT than before operation, and the observation group had better decline degree than the control group. Their difference was statistically significant（P〈0.05）. In postperative 24 h, both groups had lower APTT than before operation, and the observation group had better decline degree than the control group. Their difference was not statistically significant（P〉0.05）. Conclusion For gastrointestinal neoplasms, laparoscopic surgery is superior in traumatic and complications to laparotomy. But in blood coagulation, both treatments were hypercoagulable, and laparoscopic method is more obvious. Appropriate treatment method should be chosen according to patient＇s physical condition.