直肠癌患者手术前后凝血状态变化的研究

目的：通过研究直肠癌患者凝血与纤溶系统的变化，观察其与手术切除与否、淋巴结转移、细胞分化程度等的关系。方法：选取直肠癌患者58例，于术前及术后两周检测PAGT、PT、APTT、TFPI、D－二聚体、t-PA:a等指标；同期52例非肿瘤病人作为对照组。结果：直肠癌患者较对照组血小板聚集增强（P＜0．05），凝血酶原时间、活化部分凝血活酶时间明显缩短，组织因子途径抑制物降低（P＜0．05），D－二聚体和t-PA:a显著升高（P＜0．01），存在淋巴结转移和低分化腺癌者尤为明显（P＜0．05或P＜0．01），手术切除后有所改善。结论：直肠癌患者处于高凝和纤溶亢进状态，在淋巴结转移和癌细胞分化差的病人中尤为明显；应用抗凝和抗纤溶药物可能对直肠癌的预防有一定作用。

Clinical Study of Pre-and Post-Operational Coagulation Alterations in Rectal Carcinoma Patients

Objective To study the coagulation and fibrinolytic abnormalities in rectal carcinoma and their relationship with operation,lymphatic metastasis and cell differentiation. Methods Fifty-eight rectal carcinoma patients were selected. PAGT,PT,APTT,TFPI,D-Dimer and t-PA:a were assayed at two weeks pre-and post operation. Results We found increased PAGT (P<0.05),shortened PT,APTT and decreas TFPI(P<0.05),elevated D-dimer and t-PA:(P<0.01) in patients suffered from rectal carcinoma, being more prominent in those with metastasis. This assessment was improved after operation. Conclution Hypercoagulation and fibrinolytic accentuation exist in patients with rectal carcinoma, especially in those have metastasis and poor differentiation. Anti-coagulative and fibrinolytic drugs may be used to improve the prognosis.