CAJ | 학술논문

目的研究开腹手术(AH)和腹腔镜手术(LH)对卵巢子宫内膜异位症患者止血功能的影响.方法选择60例子宫内膜异位症患者,ASA Ⅰ～Ⅱ级,将其随机分为两组,每组30例,分别行AH和LH.分别于麻醉前,术中15 min、30 min、60 min和术毕,术后24 h、48 h、72 h共8个时间点抽取外周静脉血测量两组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、血小板计数(PLT)、D-二聚体(DD)、纤维蛋白原(FBG)和血管性血友病因子(vWF)的含量.结果两组患者术中15 min、30 min、60 min和术毕时PT、APTT、TT均较麻醉前延长,但是AH组较LH组延长更明显(P＜0.05).两组患者术毕和术后24 h、48 h PLT、FBG的含量均较麻醉前降低,但相同时间点PLT和FBG AH组较LH组降低更明显(P＜0.05).两组患者术后24 h、48 h DD和vWF的含量均较麻醉前升高(P＜0.01),但相同时间点DD和vWF AH组较LH组升高更明显(P＜0.05).结论腹腔镜下卵巢子宫内膜异位症手术较传统开腹手术对机体的凝血功能影响相对较小.
목적 연구개복수술(AH)화복강경수술(LH)대란소자궁내막이위증환자지혈공능적영향.방법 선택60례자궁내막이위증환자,ASA Ⅰ～Ⅱ급,장기수궤분위량조,매조30례,분별행AH화LH.분별우마취전,술중15 min、30 min、60 min화술필,술후24 h、48 h、72 h공8개시간점추취외주정맥혈측량량조환자응혈매원시간(PT)、활화부분응혈활매시간(APTT)、응혈매시간(TT)、혈소판계수(PLT)、D-이취체(DD)、섬유단백원(FBG)화혈관성혈우병인자(vWF)적함량.결과 량조환자술중15 min、30 min、60 min화술필시PT、APTT、TT균교마취전연장,단시AH조교LH조연장경명현(P＜0.05).량조환자술필화술후24 h、48 h PLT、FBG적함량균교마취전강저,단상동시간점PLT화FBG AH조교LH조강저경명현(P＜0.05).량조환자술후24 h、48 h DD화vWF적함량균교마취전승고(P＜0.01),단상동시간점DD화vWF AH조교LH조승고경명현(P＜0.05).결론 복강경하란소자궁내막이위증수술교전통개복수술대궤체적응혈공능영향상대교소.
Objective To explore the effect of laparotomy surgery (AH) and laparoscopic surgery (LH) on hemostatic function in patients with ovarian endometriosis.Methods 60 ASA Ⅰ-Ⅱ patients with endometriosis were selected and then randomly divided into two groups,30 for each group.The two groups received AH or LH.Prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),platelet count,D-dimer,fibrinogen,and von Willebrand factor content were detected before anesthesia,at 15,30,and 60 minutes during anesthesia,completion of procedure,and 24,48,and 72 h after anesthesia.Results As compared with the baselines,PT,APTT,and TT were prolonged in group AH and group LH at 15,30,and 60 minutes during anesthesia,and completion of procedure (P＜0.05),and they were longer in group AH than in group LH (P＜0.05).The contents of PLT and FBG were declined in both groups at completion of anesthesia and 24,48,and 72 after anesthesia as compared with the baselines (P＜0.05),and they were lower in group AH than in group LH at the same time points after anesthesia (P＜0.05).The contents of DD and vWF were significantly higher in both group AH and group LH as compared with the baselines (P＜0.01),and they were significantly higher in group AH than in group LH at the same time points after anesthesia (P＜0.05).Conclusions Laparoscopic surgery has less effect on hemostatic function than laparotomy surgery in patients with ovarian endometriosis.