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中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (04) : 307 -310. doi: 10.3877/cma.j.issn.1674-0793.2015.04.013

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论著

腹腔镜手术与传统开腹手术对胃肠肿瘤患者的临床疗效及血凝状态的影响
朱绍华1,()   
  1. 1. 710032 西安,第四军医大学西京消化病医院消化内科
  • 收稿日期:2015-06-16 出版日期:2015-08-01
  • 通信作者: 朱绍华

Comparison of laparoscopic surgery and laparotomy on the clinical efficacy and coagulation status of gastrointestinal cancer patients

Shaohua Zhu1,()   

  1. 1. Department of Internal Medicine, Xijing Digestive Disease Hospital of the Fourth Military Medical University, Xi’an 710032, China
  • Received:2015-06-16 Published:2015-08-01
  • Corresponding author: Shaohua Zhu
  • About author:
    Corresponding author: Zhu Shaohua, Email:
引用本文:

朱绍华. 腹腔镜手术与传统开腹手术对胃肠肿瘤患者的临床疗效及血凝状态的影响[J/OL]. 中华普通外科学文献(电子版), 2015, 09(04): 307-310.

Shaohua Zhu. Comparison of laparoscopic surgery and laparotomy on the clinical efficacy and coagulation status of gastrointestinal cancer patients[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(04): 307-310.

目的

探讨腹腔镜手术与开腹手术在胃肠肿瘤治疗中的效果,并分析两种手术方式对患者血凝状态的影响。

方法

选取本院2013年1月至2014年12月间收治的120例胃肠肿瘤患者作为研究对象,依据不同手术方式分为腹腔镜组(65例)与开腹组(55例),对两组患者临床疗效与凝血指标以及并发症进行对比。

结果

腹腔镜组手术时间、术中出血量、胃肠功能恢复时间和住院时间均明显低于开腹组,差异有统计学意义(P<0.05)。术后两组1 h、24 h时凝血酶原时间(PT)和D-二聚体(D-D)水平较术前有明显的变化,腹腔镜组变化程度大于开腹组,差异有统计学意义(P<0.05)。腹腔镜组术后并发症发生率9.2%,低于开腹组25.5%,两组比较差异有统计学意义(P<0.05)。

结论

临床中对于胃肠肿瘤患者采取腹腔镜手术较开腹手术创伤小,并发症少,但是两种治疗方式均会导致患者出现血液高凝状况,以腹腔镜手术更为明显,临床中应依据患者的身体状况选择合理的手术方式。

Objective

To compare the effect of laparoscopic surgery and laparotomy in gastrointestinal cancer patients, and to analyze the effect of both therapies on the coagulation status.

Methods

One hundred and twenty patients with gastrointestinal cancer between January 2013 and December 2014 were selected and divided into laparoscopic group and open surgery group according to different surgical methods. The clinical effect of both groups were observed and coagulation parameters were detected.

Results

The operation time, blood loss, gastrointestinal function recovery time and hospital stay of laparoscopic group were significantly lower than those of laparotomy group, the differences were statistically significant(P<0.05). 1 h, 24 h postoperative prothrombin time and D-dimer level changed in the two groups, and the changes in laparoscopic group were significantly bigger (P<0.05). The postoperative complication incidence in the laparoscopic group and open surgery group was 9.2% and 25.5%, respectively(P<0.05).

Conclusion

Compared with laparotomy, laparoscopic surgery has less trauma and fewer complications for gastrointestinal cancer patients. Since both surgeries can lead to high coagulation status, especially for laparoscopic surgery, a rational choice should be made based on the individual physical condition.

表1 腹腔镜组与开腹组患者手术相关指标对比观察(±s,t检验)
表2 腹腔镜组与开腹组患者凝血状态观察(±st检验)
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