老年胃肠道肿瘤患者术后D-二聚体的变化及意义

目的探讨老年胃肠道肿瘤患者手术前后D-二聚体的变化及其临床意义,为患者术后抗凝治疗,预防继发性血栓形成提供临床依据。方法将88例胃肠道肿瘤患者分为恶性肿瘤组及非恶性肿瘤组,其中恶性肿瘤组又分为老年恶性肿瘤组及非老年恶性肿瘤组,应用酶联免疫方法检测各组患者手术前后血浆中D-二聚体的水平,对数据进行统计学分析。结果老年与非老年胃肠道恶性肿瘤患者以及非恶性肿瘤患者术后血浆D-二聚体水平显著高于术前（P〈0.05）;恶性肿瘤组患者术前血浆D-二聚体水平显著高于非恶性肿瘤组患者术前水平（P〈0.05）;老年恶性肿瘤组患者术后血浆D-二聚体水平显著高于非老年恶性肿瘤组患者术后水平（P〈0.05）。结论手术对老年胃肠道恶性肿瘤患者D-二聚体有明显的活化作用,并能促进高凝状态的发生,故应重视手术后的抗凝措施,防止血栓形成。

Significance of the Change of D-dimer in Elder Patients with Gastrointestinal Tumor After Surgery

Objective To investigate the significance of the change of D- dimer in elder patients with gastrointestinal tumor and provide the clinical basis of the anticoagulation treatmemt or prevention of the secondary thrombus after surgery. Methods Dividing the patients into malignant tumor group and non- malignant tumor group,which the malignant tumor patients were grouped into elder malignant tumor group and non- elder malignant tumor group. Detecting and comparing the level of D- dimer of every group after surgery with ELISA. Results The level of D- dimer in serum after surgery is significantly higher than it before surgery in elder malignant tumor group,non- elder malignant tumor group and non- malignant tumor group（ P〈 0. 05）. The level of D- dimer in serum before surgery in malignant tumor group patients is significantly higher than non- malignant tumor group（ P〈 0. 05）. The level of D- dimer in serum after surgery in elder malignant tumor group patients is significantly higher than non- elder malignant tumor group（ P〈 0. 05）. Conclusion There is obvious activation of D- dimer and promotion of the formation of hypercoagulative state in elder malignant tumor patients with surgery.Attention to the anticoagulant therapy postoperation should be paid,and the occurence of thrombus be prevented.