胃癌患者全胃联合脾切除术对血小板活化的影响

目的观察胃癌患者全胃联合脾切除术对血小板活化的影响。方法选取13例因胃癌行全胃联合脾切除术的患者为研究对象,利用流式细胞技术,检测血小板α-颗粒膜糖蛋白(CD62P)作为血小板活化的标志物,分别于术前1 d、术后1周、术后2周及术后1个月测定患者的外周血血小板CD62P阳性表达率和血小板计数并进行比较。结果所有患者术后恢复良好,未出现与手术相关的并发症。术后1周的血小板计数与术前比较,差异有统计学意义(P<0.01);术后2周的血小板计数与术前、术后1周和术后1个月比较,差异均有统计学意义(P<0.01);术后1个月的血小板计数与术前比较,差异无统计学意义(P>0.05)。术后1周的CD62P阳性表达率与术前、术后2周、术后1个月比较,差异均有统计学意义(P<0.05);术后2周、术后1个月的CD62P阳性表达率与术前比较,差异均有统计学意义(P<0.01)。结论因胃癌行全胃联合脾切除术的患者术后血小板活化状态没有进展,不会增加血栓发生的风险性。

Influence of Gastric Cancer Total Gastrectomy with Splenectomy on Platelet Activation

Objective To observe by flow cytometry the platelet activation changes in gastric carcinoma(GC) patients before and following total gastrectomy(TG) with splenectomy.Methods Thirteen patients who underwent TG with splenectomy for GC were chosen as subjects in this study.Using CD62P as a marker of platelet activation,the positive expression of peripheral platelet CD62P and platelet count were determined and compared by flow cytometry before operation,and 1,2 weeks,1 month after.Results Platelet count increased significantly 1,2 weeks after operation when compared with pre-operation(P<0.01),reaching maximum in week 2(P<0.01).But the increase in Platelet count was not significant 1 month after operation(P>0.05).Expression of CD62P was significantly reduced after operation(P<0.01),reaching minimum in week 1.No postoperative complications occurred in any of the patients.Conclusion There is no progress in platelet activation in GC patients after TG with splenectomy,not resulting in the increase of thrombus risk.