CAJ | 학술논문

目的：探讨腹腔镜胃癌手术对患者凝血功能的影响。方法选择71例胃癌患者为研究对象，按手术方式不同分为腹腔镜手术组（n＝34）和开腹手术组（n＝37）。分别于手术前、手术结束即刻以及术后24 h测定2组患者的D-二聚体（D-D）、纤维蛋白原（FIB）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT），并计算凝血酶原国际标准化值（INR），观察2组患者凝血功能的变化。结果腹腔镜手术组和开腹手术组手术结束即刻及术后24 hAPTT、INR较术前无显著差异（P＞0．05）；术后24 h PT显著低于术前（P＜0．05），但2组间无显著性差异（P＞0．05）；术后即刻及术后24 h 2组患者FIB以及D-D较术前均显著升高，且2组间差异有统计学意义（P＜0．05）。结论患者在进行腹腔镜胃癌手术及常规开腹手术后，血液均呈高凝状态，有术后发生血栓的风险，且腹腔镜胃癌手术对患者凝血功能的影响更为明显，应在围术期采取相应的预防措施。
목적：탐토복강경위암수술대환자응혈공능적영향。방법선택71례위암환자위연구대상，안수술방식불동분위복강경수술조（n＝34）화개복수술조（n＝37）。분별우수술전、수술결속즉각이급술후24 h측정2조환자적D-이취체（D-D）、섬유단백원（FIB）、응혈매원시간（PT）、활화부분응혈활매시간（APTT），병계산응혈매원국제표준화치（INR），관찰2조환자응혈공능적변화。결과복강경수술조화개복수술조수술결속즉각급술후24 hAPTT、INR교술전무현저차이（P＞0．05）；술후24 h PT현저저우술전（P＜0．05），단2조간무현저성차이（P＞0．05）；술후즉각급술후24 h 2조환자FIB이급D-D교술전균현저승고，차2조간차이유통계학의의（P＜0．05）。결론환자재진행복강경위암수술급상규개복수술후，혈액균정고응상태，유술후발생혈전적풍험，차복강경위암수술대환자응혈공능적영향경위명현，응재위술기채취상응적예방조시。
Obj ective To investigate the effects of laparoscopic surgeryon coagulation func-tion in patients with gastric cancer.Methods A total of 71 patients with gastric cancer were divid-ed into laparoscopic group and laparotomy group.Levels of D-dimer (D-D)and fibrinogen (FIB), prothrombin time (PT),activated partial thromboplastin time (APTT)were detected before opera-tion,end of operation and 24 hours after operation.Prothrombin time-international normalized ratio (INR)was calculated and coagulation function was observed in both groups.Results There were no significant differences in APTT and INR before and after operation in both groups (P>0 .05 ). PT at 24 hours after operation was significantly shorter than that before operation(P<0 .05 ),but there was no significant difference between two groups (P>0 .05 ).Levels of FIB and D-D in-creased after operation,and there were significant differences between two groups (P<0 .05 ). Conclusion Blood hypercoagulability and potential thrombosis are associated with patients with la-paroscopic surgery or laparotomy surgery.Preventions during preoperative period should be conduct-ed to mitigate the effects of laparotomy surgery on coagulation function.