腹腔镜全子宫切除术对血小板参数及血栓蛋白的影响.docVIP

腹腔镜全子宫切除术对血小板参数及血栓蛋白的影响 　　　作者：顾晓琴，任慕兰 作者单位：东南大学医学院附属扬州一院，江苏 扬州，225000 　　【摘要】 目的：观察妇科腹腔镜手术对患者血小板参数及血栓蛋白的影响，了解腹腔镜手术是否存在深静脉血栓的高危因素。方法：选择腹腔镜及开腹全子宫切除术各19例患者，于术前及手术结束时抽静脉血分别检查血小板数量(platelet count,PLT)、平均血小板体积(mean platelet volume,MPV)、血小板分布宽度(platelet distribution width,PDW)及血栓蛋白(thrombomodulin，TM),观察在CO2气腹下腹腔镜手术及开腹手术对上述指标的影响。结果：两组术后PLT均有不同程度下降，但无统计学意义(P0.05)，术后PDW，MPV，TM的变化较小，差异无统计学意义。结论：腹腔镜全子宫切除术对血小板参数及血栓蛋白产生的影响与开腹手术相比差异无统计学意义。 　　【关键词】 腹腔镜术;子宫切除术;血小板参数;血栓蛋白;血栓形成 　　The effect of laparoscopic hysterectomy on the parameters of platelet and thrombomodulin GU Xiaoqin,REN Mulan.Affiliated Yangzhou Hospital,Medical College of Southeast University，Yangzhou 225000,China 　　【Abstract】 Objective:To investigate the effect of laparoscopic hysterectomy on the parameters of platelet and thrombomodulin.Methods:Thirtyeight patients suffering from hysteromyoma were randomly assigned to undergo open (group A,n=19) or laparoscopic hysterectomy (group B,n=19) by the same surgical and anaesthetic team.Blood samples were taken preoperatively and at the end of the procedure.The following parameters were measured and compared within each group and between groups:platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),thrombomodulin(TM).Results:After operation PLT decreased slightly but not statistically significantly in both groups.The change of PDW，MPV and TM is not statistically significant.No patient from either group suffered thrombosis or abnormal bleeding as a postoperative complication.Conclusions:Laparoscopic procedures,as compared to open surgery,did not lead to increase of platelet parameters and thrombomodulin.It was not correct that laparoscopic hysterectomy should multiply the incidence of thrombosis. 　　【Key words】 Laparoscopy;Hysterectomy;Parameters of platelet;Thrombomodulin;Thrombosis 　　腹腔镜手术目前广泛用于妇科临床，由于手术本身的特殊性，如体位、气腹等因素，一些学者认为腹腔镜手术会引起血凝状态的改变，从而导致静脉血栓产生的危险性增加，本文通过观察腹腔镜全子宫切除手术前后血小板参数及血栓蛋白的变化分析，并与开腹全子宫切除术参考对照，比较了两种手术方式对血凝状态及内皮细胞功