腹腔镜与开腹远端胃癌根治术疗效及对凝血功能影响的对比研究.pdf

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1、【摘要】目的对比腹腔镜与开腹远端胃癌根治术的疗效及对凝血功能的影响。方法选取行腹腔镜远端胃癌根治术的患者56例(观察组)及同期开腹远端胃癌根治术患者56例(对照组)。对两组患者的术中及术后情况、淋巴结清扫数目、并发症等进行比较分析，并检测比较两组患者术前、术后24h凝血酶原国际标准化值(INR)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D一二聚体(D—D)以及纤维蛋白原(FIB)水平。结果观察组手术时间长于开腹组，而术中出血量、切1：3长度、术后首次肛门排气时间、术后镇痛药使用次数、住院时间均少于开腹组，差异均有统计学意义(均P

2、<0．01o与手术前比较，仅观察组患者PT显著延长，差异有统计学意义(P

3、症，应予以重视。【关键词】胃癌胃切除术腹腔镜凝血功能ComparisonoflaparoscopicassistedwithopendistalgastrectomyforpatientswithgastriccancerXUJi，WUFang，N／Haibin，eta／．DepartmentofGastrointestinalSurgery．Z．heiiangProvincialPeopleSHospita1．Huagzhou310014China【Abstract】ObjectiveTocomparetheclinicaleffectsbe

4、tweenlaparoscopicassistanceandopendistalgastrectomyforpatientswithgastriccancerMethodsFiftysixpatientswithgastriccancerunderwentlaparoscopicassistancedistalgastrecto——my(groupL)and56casesreceivedopendistalgastrectomy(groupO)wereincludedinthestudyTheintraoperativeandpost—oper

5、ativeinformation，thenumberofdissectedlymphnodes，postoperativecomplicationswerecomparedbetweentwogroupsTheprothrombininternationalnormalizedvalue(INR)，prothrombintime(PT)，activatedpartialthromboplastintime(APTT)，D—dimerandfibrinogen(FIB)levelsweremeasuredbeforeandafteroperati

6、oninbothgroupsResultsTheoperativetimeingroupLwassignificantlylongerthanthatingroupO．However，themeanbloodloss，thefrequencyofanalgesicsuseafteroperationwerelessandfirstflatustime，totalhospitalstaywereshorteringroupLthanthoseingroupO(allP<001)．Thepostoperativeprothrombintime(PT

7、)wassignificantlyincreasedthanthatbeforeoperationingroupL(P

8、IB)levelsingroupLweresignificantlyhigherthanthoseingroupO(P<005)Thepostoper