CAJ | 학술논문

目的：探讨凝血功能变化对盆腔术后并发下肢深静脉血栓(LEDVT)形成的诊断及预后价值，为其临床研究提供依据。方法共纳入40例我院妇科盆腔术后并发LEDVT患者(A组)及40例未并发LEDVT患者(B组)，同时随机抽取门诊健康患者40例(C组)，详细记录相关信息。于术前、术后24 h、7 d空腹抽取静脉血进行凝血功能检查。结果三组间PT、APTT及TT术前比较差异无统计学意义(P>0.05)；A组FIB及D-dimer均明显高于B组及C组，差异有统计学意义(P<0.05)；与C组相比，B组D-dimer水平明显增高，差异有统计学意义(P<0.05)，但FIB比较差异无统计学意义(P>0.05)。三组间PT、APTT及TT术后24 h比较差异无统计学意义(P>0.05)；与术前相比，A组FIB及D-dimer均明显增高(P<0.05)，B组及C组升高差异无统计学意义(P>0.05)；同时A组FIB及D-dimer高于B组及C组，差异有统计学意义(P<0.05)；B组D-dimer水平明显高于C组，差异有统计学意义(P<0.05)，但FIB比较差异无统计学意义(P>0.05)。与术后24 h比较，A组与B组FIB、D-dimer水平明显下降(P<0.05)；三组间PT、APTT、TT、FIB、D-dimer水平术后7 d比较差异无统计学意义(P>0.05)。结论行盆腔手术治疗的患者应术前及术后早期进行凝血功能的检查，尤其是FIB、D-dimer水平检测，并对检测异常患者及时给予相应的对症治疗措施，可降低其发生LEDVT的风险，同时凝血功能检查可作为疗效评价指标之一。
목적：탐토응혈공능변화대분강술후병발하지심정맥혈전(LEDVT)형성적진단급예후개치，위기림상연구제공의거。방법공납입40례아원부과분강술후병발LEDVT환자(A조)급40례미병발LEDVT환자(B조)，동시수궤추취문진건강환자40례(C조)，상세기록상관신식。우술전、술후24 h、7 d공복추취정맥혈진행응혈공능검사。결과삼조간PT、APTT급TT술전비교차이무통계학의의(P>0.05)；A조FIB급D-dimer균명현고우B조급C조，차이유통계학의의(P<0.05)；여C조상비，B조D-dimer수평명현증고，차이유통계학의의(P<0.05)，단FIB비교차이무통계학의의(P>0.05)。삼조간PT、APTT급TT술후24 h비교차이무통계학의의(P>0.05)；여술전상비，A조FIB급D-dimer균명현증고(P<0.05)，B조급C조승고차이무통계학의의(P>0.05)；동시A조FIB급D-dimer고우B조급C조，차이유통계학의의(P<0.05)；B조D-dimer수평명현고우C조，차이유통계학의의(P<0.05)，단FIB비교차이무통계학의의(P>0.05)。여술후24 h비교，A조여B조FIB、D-dimer수평명현하강(P<0.05)；삼조간PT、APTT、TT、FIB、D-dimer수평술후7 d비교차이무통계학의의(P>0.05)。결론행분강수술치료적환자응술전급술후조기진행응혈공능적검사，우기시FIB、D-dimer수평검측，병대검측이상환자급시급여상응적대증치료조시，가강저기발생LEDVT적풍험，동시응혈공능검사가작위료효평개지표지일。
Objective To explore the change and clinical significance of coagulation function in patients with lower extremity deep venous thrombosis (LEDVT) after gynecological pelvic surgery. Methods Automated co-agulation analyzer was used to detect plasma prothrombin times (PT),activated partial thromboplastin times (APTT), plasma thrombin times (TT), plasma fibrinogen (FIB) concentrations, and D-dimer levels in 40 patients with LEDVT after gynecological pelvic surgery and 40 patients without LEDVT after gynecological pelvic surgery,then the results were compared with 40 normal women (control group) after physical examination. Results The levels of PT, APTT, TT were no statistically significant differences (P>0.05) between three groups preoperative. The levels of FIB and D-dimer in group A were higher than that in group B and group C. The differences were statistically significant (P<0.05). The levels of D-dimer in group B was higher than that in group C. The differences was statistically significant (P<0.05). The differences of FIB levels was not obvious between group B and group C (P>0.05). The levels s of PT, APTT, TT were no statistically significant differences (P>0.05) between three groups after 24 h of surgery. The levels of FIB and D-dimer in group A were higher than that in group B and group C. The differences were statistically signifi-cant (P<0.05). The levels of D-dimer in group B was higher than that in group C. The differences was statistically sig-nificant (P<0.05). The levels of FIB was no statistically significant differences (P>0.05) between group B and group C. The levels of FIB and D-dimer were lower after 7 d of surgery than that after 24 h of surgery between three groups. The differences was statistically significant (P<0.05). The levels of PT, APTT, TT, FIB and D-dimer were no statisti-cally significant differences between three groups after 7 d of surgery (P>0.05). Conclusion Coagulation function detection,especially FIB and D-dimer detection,has important effect for laboratory examination of patients with LED-VT after gynecological pelvic surgery, which can be used for early prediction of gynecological pelvic surgery com-bined with LEDVT,and it has a certain directive function for treatment and degree of recovery of patients with LED-VT after gynecological pelvic surgery.