摘要
目的分析在采取腹腔镜或开腹下脾切除术后患者下肢深静脉血栓的形成情况,同时分析血栓形成与血小板上升的关联性。方法将本院于2019年6月-2021年6月收治的需要采取脾切除术治疗的患者共18例作为本次观察对象,其中腔镜下脾切除术6例,开腹下脾切除术12例,分析患者在采取不同的手术治疗下的手术时间,术后患者DVT发生率以及DVT高危率,还需注意观察患者D-二聚体水平以及D-二聚体对患者DVT发生的敏感性及特异性。结果在两种不同的手术治疗下可见,采取腹腔镜脾切除术治疗的患者其手术时间相对更短,DVT高危率明显更高,但两组无差异(P>0.05),但开腹脾切除术患者的DVT发生率明显更低于腹腔下脾切除术患者(P<0.05);而在两种不同术式术后的D-二聚体水平对比中可见,腹腔镜手术中D-二聚体水平超过0.5μg/mL的患者为4例,但开腹脾切除术治疗的患者D-二聚体水平超过0.5μg/mL的患者为2例(P<0.05)。结论在临床中需要医务人员加强对患者手术后的指标观察,通过D-二聚体观察患者血小板上升情况,对指标异常的患者应及时采取合理的干预措施,降低DVT发生率。
Objective To analyze the formation of lower limb deep vein thrombosis in patients after laparoscopic or open abdominal splenectomy,and to analyze the association of thrombosis and platelet rise.Methods A total of 18 patients requiring splenectomy from June 2019 to June 2021,including 6 patients with endoscopic splenectomy and 12 splenbectomy,to analyze the different surgical times,DVT incidence and DVT risk,D-dimer level and sensitivity and specificity of D-dimer to DVT.Results It can be seen under two different surgical treatments,patients treated with laparoscopic splenectomy had a relatively shorter surgical time,the DVT was significantly higher,however,there was no difference between the two groups(P>0.05),however,the incidence of DVT was significantly lower in patients with open abdominal splenectomy than in those with subabdominal splenectomy(P<0.05).But as seen in the comparison of D-dimer levels after two different surgical procedures,four patients with D-dimer levels exceeding 0.5μg/mL in laparoscopic surgery,however,two patients treated with open abdominal splenectomy exceeded 0.5μg/mL(P<0.05).Conclusion In clinical practice,medical personnel are required to strengthen the index observation of patients after surgery,observe the platelet rise through D-dimer,and take reasonable intervention measures in time to reduce the incidence of DVT.
作者
夏孙明
陆学安
XIA Sunming;LU Xuean(Donghai County People's Hospital,Lianyungang,Jiangsu 222300)
出处
《智慧健康》
2022年第5期54-56,共3页
Smart Healthcare
关键词
腹腔镜
脾切除术
开腹
下肢深静脉血栓
Laparoscopic
Splenectomy
Open abdomen
Deep vein thrombosis in the lower limbs
