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1. 重庆医科大学附属第一医院呼吸与危重医学科
2. 重庆医科大学附属第一医院放射科
纸质出版日期:2016,
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[1]侯飞飞,吕富荣,王晓慧,张锐,陈虹.腹腔镜与开腹手术术后静脉血栓栓塞症的临床分析[J].重庆医科大学学报,2016,41(01):102-105.
Hou Feifei, Lyu Furong, Wang Xiaohui, et al. Clinical analysis of the venous thromboembolism after laparoscopic surgery and open surgery[J]. Journal of Chongqing Medical University, 2016,41(1):102-105.
[1]侯飞飞,吕富荣,王晓慧,张锐,陈虹.腹腔镜与开腹手术术后静脉血栓栓塞症的临床分析[J].重庆医科大学学报,2016,41(01):102-105. DOI: 10.13406/j.cnki.cyxb.000836.
Hou Feifei, Lyu Furong, Wang Xiaohui, et al. Clinical analysis of the venous thromboembolism after laparoscopic surgery and open surgery[J]. Journal of Chongqing Medical University, 2016,41(1):102-105. DOI: 10.13406/j.cnki.cyxb.000836.
目的:了解腹腔镜和开腹手术后静脉血栓栓塞症(venous thromboembolism
VTE)的发生率及腹腔镜和开腹手术对外周血凝血功能的影响
初步探讨与开腹手术比较
腹腔镜手术是否更易增加血液高凝状态和VTE的发生。方法:收集我院2011年1月到2014年12月妇科、胃肠外科、肝胆外科、泌尿外科腹腔镜及开腹手术患者的临床资料
并对术后并发下肢深静脉血栓形成(deep vein thrombosis
DVT)和肺血栓栓塞症(pulmonary thromboembolism
PTE)患者的临床资料进行回顾性分析
比较腹腔镜及开腹手术患者手术前后凝血功能相关指标的改变情况。结果:1腹腔镜手术10 850例
术后并发VTE共27例
发生率0.25%
其中DVT 23例
发生率0.21%
PTE 6例
发生率0.06%;2开腹手术16 789例
术后并发VTE共31例
发生率0.18%
其中DVT 27例
发生率0.16%
PTE 6例
发生率0.04%;3腹腔镜及开腹手术后VTE、DVT、PTE的发生率分别比较均无统计学差异(P>0.05);4腹腔镜和开腹手术VTE患者术后的凝血酶原时间(prothrombin time
PT)明显延长
纤维蛋白原(fibrinogen
FIB)、纤维蛋白原降解产物(fibrinogen degration products
FDP)、D-二聚体(D-dimer
D-D)明显增高
与术前比较差异有统计学意义(P<0.05);腹腔镜和开腹手术VTE患者手术前后比较
其PT、FIB、FDP、D-D水平无明显统计学差异(P>0.05)。结论:与开腹手术相比
腹腔镜手术并没有显著性地增加术后血液高凝状态及VTE的发生率。
Objective:To understand the incidence of venous thromboembolism(VTE)in laparoscopic and open surgery and effects of laparoscopic and open surgery on coagulation status
and to discuss whether laparoscopic surgery can increase the occurrence of VTE and hypercoagulability of blood compared with open surgery. Methods:Clinical data of patients who underwent open and laparoscopic surgery in gynecology
gastrointestinal surgery
liver and gallbladder surgery
urology in the First Affiliated Hospital of Chongqing Medical University from January 2011 and December 2014 were obtained. The clinical data of patients with deep vein thrombosis(DVT)and pulmonary thromboembolism(PTE)after laparoscopic and open surgery were retrospectively analyzed. The preoperative and postoperative coagulation parameters in patients with VTE were compared between laparoscopic and open surgery. Results:1A total of 10 850 patients underwent laparoscopic surgery;VTE was seen in 27 patients and DVT was seen in 23 patients after laparoscopic surgery. The incidence of VTE and DVT were 0.25% and 0.21%
respectively. PTE was seen in 6 patients after laparoscopic surgery
the incidence of PTE was 0.06%. 2A total of 16
789 patients underwent open surgery;VTE was seen in 31 patients and DVT was seen in 27 patients after open surgery;the incidences of VTE and DVT were 0.18% and 0.16% respectively. PTE was seen in 6 patients after open surgery;the incidence of PTE was 0.04%.3 There was no significant difference in incidence of VTE
DVT
and PTE between laparoscopic cases and open cases
respectively(P >0.05). 4The level of prothrombin time(PT)
fibrinogen(FIB)
fibrinogen degration products(FDP)and D-dimer(D-D)of patients with VTE increased significantly postoperatively compared with those preoperatively in laparoscopic surgery group and open surgery group(P<0.05)
but there was no significant difference between the laparoscopic surgery group and open surgery group(P >0.05). Conclusion:Laparoscopic surgery dose not increase the incidence of VTE and hypercoagulable state among patients after the surgery.
腹腔镜手术静脉血栓栓塞症开腹手术
laparoscopic surgeryvenous thromboembolismopen surgery
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