腹腔镜胃癌根治术后患者凝血功能和炎症因子的变化

目的 研究腹腔镜胃癌根治术后患者凝血功能和炎症因子的变化.方法 选择胃癌患者82例,根据手术治疗方法的不同分为两组,对照组采用常规开腹治疗,观察组采用腹腔镜治疗.分别观察两组患者术前、术后12 h、24 h的凝血酶原时间、纤维蛋白原、D-二聚体、肿瘤坏死因子-α、白介素-6、白介素-8水平;并观察术后血栓发生和肿瘤复发情况.结果 与术前相比,两组的凝血酶原时间明显降低(P＜0.05),纤维蛋白原和D-二聚体水平明显升高(P＜0.05),且术后24h观察组的变化幅度明显大于对照组(P＜0.05);与术前相比,两组的肿瘤坏死因子-α、白介素-6、白介素-8水平均明显升高(P＜0.05),且观察组明显低于对照组(P＜0.05);观察组的血栓发生率明显高于对照组(P＜0.05);观察组的肿瘤复发率明显低于对照组(P＜0.05).结论 腹腔镜胃癌根治术对机体创伤小,可减少炎症介质的释放,抑制机体炎症反应,对免疫功能的影响较小,但对凝血功能有严重影响,临床治疗时引起重视.

Effeets of Laparoscopic Gastric Cancer Radical Surgery on Blood Coagulation and Inflammatory Factor

Objective To investigate the effect of laparoscopic gastric cancer radical surgery on blood coagulation and inflammatory factor.Methods 82 cases of gastric cancer were divided into 2 groups according to the surgery methods,the control group was treated with laparotomy,the observation group was treated with laparoscopic treatment.The level of rothrombin time,fibrinogen and D dimer,interleukin-6,interleukin-8 and tumor necrosis factor alpha were analyzed before the surgcry and 12 h,24 h after the surgery of the 2 groups.The postoperative thrombosis and tumor recurrence rate were also analyzed.Results Compared with before the surgery,the prothrombin time of the 2 groups significantly decreased(P ＜ 0.05),the fibrinogen and D-dimer increased significantly (P ＜ 0.05),and the observation group was significantly greater than the control group (P ＜ 0.05);Compared with before the surgery,the tumor necrosis factor alpha,irnterleukin 6 and interleukin 8 levels were significantly higher (P ＜0.05),the observation group was significantly lower than the control group (P ＜ 0.05);The incidence of thrombosis of the observation group was obviously higher than that of the control group (P ＜0.05);The tumor recurrence rate of the observation group was obviously lower than the control group (P ＜ 0.05).Conclusion The laparoscopic gastric cancer radical surgery has small trauma,can reduce the release of inflammatory mediators,inhibit the inflammatory response,but it has a serious intluence on blood coagulation function,should pay attention to it in the clinical treatment.