腹腔镜手术与开腹手术对胃癌患者凝血功能的影响

目的探讨腹腔镜与开腹手术对胃癌患者凝血功能的影响。方法胃癌患者90例，45例行腹腔镜手术（腹腔镜组）,45例行开腹手术（开腹组），测定两组患者术前、术后24h的凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、D-二聚体含量，并进行比较。结果组内比较，术前、术后两组患者的PT、APTT、INR比较，差异均无统计学意义（P〉 0.05）;组间比较，两组患者术后的PT水平与术前比较，羞异有统计学意义（P〈0.05），APTT、INR数值与术前比较,差异均无统计学意义（P〉0.05）。两组术前FIB、D-D水平比较，差异无统计学意义（P〉 0.05），术后两组FIB、D-D水平比较，差异有统计学意义（P〈 0.05）;组间比较，术后两组的FIB、D-D水平均高于术前，差异有统计学意义（P〈 0.05）。结论两种术式治疗胃癌均可使患者的血液处于高凝状态，但腹腔镜手术术后造成患者高凝状态的几率更高，形成血栓的风险更大，应在围术期对患者采取预防措施。

Effects of laparoscopic and laparotomy operation on coagulation functions of patients with gastric carcinoma

Objective To explore the effects of laparoscopic and laparotomy operation on coagulation functions of patients with gastric carcinoma. Methods A total of 90 patients with gastric carcinoma were randomly divided into laparoscopic group and laparotomy group. Patients in the laparoscopic group accepted laparoscopic operation,patients inthe laparotomy group accepted laparotomy operation. PT,APTT,INR,FIB,D -D were tested before and lifter operation.Compared them of two groups. Results PT, APTT, INR of tow groups before and after operation showed no difference（P 〉 0.05）. PT level of tow groups after operation were shorter than before treatment, comparative difference betweenthe two groups indicated statistical significance （P 〈 0.05）. APTT JNR level of tow groups after operation showed nodifference （P 〉 0.05）. FIB, D-D level of tow groups before treatment showed no difference （P 〉 0.05）. Comparativedifference of FIB, D-D level of tow groups after treatment showed statistical significance （P 〈 0.05）. FIB, D-D level oftow groups after treatment were higher than before treatment. Conclusion Two kinds of surgical treatment of gastriccancer can make patients blood hypercoagulability in patients after laparoscopic operation, but the chance of causinghypercoagulable state in the patients with thrombosis in higher, greater risk, should be in the perioperative period ofpatients to take preventive measures.