摘要
目的 探讨老年阑尾炎患者行腹腔镜与开腹手术对凝血系统的影响差别。方法 选择2017年4月到2019年2月在我院接受急性阑尾炎手术的老年患者80例,将患者分为腹腔镜组(n=40)和开腹组(n=40),开腹组患者采用开放性阑尾切除术,腹腔镜组患者采用腹腔镜下阑尾切除术,对比两组的手术相关情况指标及对比两种手术治疗效果。结果 腹腔镜组的手术时间,住院时间、失血量、术后排气时间均小于开腹组;PLT、PT、APTT、TT在不同时间点的数据差异均有统计学意义(P<0.05);腹腔镜组与开腹组的PLT、PT、APTT、TT数据比较,差异均有统计学意义(P<0.05),PLT为腹腔镜组高于开腹组,PT、APTT、TT为腹腔镜组低于开腹组;腹腔镜组的PLT、PT、APTT、TT与开腹组的数据处理因素与时间之间均存在交互作用(P<0.05),FIB、DD在不同时间点的数据比较,差异均有统计学意义(P<0.05);腹腔镜组与开腹组的FIB、DD数据比较,差异均有统计学意义(P<0.05),FIB、DD均为腹腔镜组高于开腹组;FIB、DD的腹腔镜组与开腹组的数据处理因素与时间之间均存在交互作用(P<0.05);腹腔镜组血栓发生率高于开腹组,差异有统计学意义(P<0.05)。结论 对老年阑尾炎患者使用腹腔镜下切除手术可取得显著效果。但腹腔镜下的阑尾切除手术造成患者术后血液高凝状态的风险较高,需要在围手术期对患者采取积极的预防措施。
Objective To explore the difference in the effects of laparoscopic and open surgery on the coagulation system in elderly patients with appendicitis.Methods A total of 80 elderly patients who underwent acute appendicitis surgery in our hospital from April 2017 to February 2019 were selected and divided into the laparoscopy group(n=40)and the laparotomy group(n=40).Patients in the laparotomy group received open appendectomy,while patients in the laparoscopy group underwent laparoscopic appendectomy.The operation-related indicators and the effectiveness of two surgical treatments were compared between the two groups.Results The operation time,length of hospitalization,blood loss,and postoperative exhaust time of the laparoscopy group were less than those of the laparotomy group.The differences in the data of PLT,PT,APTT,and TT at different time points were statistically significant;the differences in the data of PLT,PT,APTT,and TT between the laparoscopy group and the laparotomy group were statistically significant(P<0.05).PLT in the laparoscopy group was higher than that in the laparotomy group,and PT,APTT,and TT in the laparoscopy group were lower than those in the laparotomy group.There was an interaction between the data processing factors of PLT,PT,APTT,and TT in the laparoscopy group and the laparotomy group and time(P<0.05).The differences in the data of FIB and DD at different time points were statistically significant(P<0.05);the differences in the data of FIB and DD between the laparoscopy group and the laparotomy group were statistically significant(P<0.05).FIB and DD in the laparoscopy group were higher than those in the laparotomy group;there was an interaction between the data processing factors of FIB and DD in the laparoscopy group and the laparotomy group and time(P<0.05).The incidence of thrombosis in the laparoscopy group was lower than that in the laparotomy group,with statistically significant difference(P<0.05).Conclusion The laparoscopic resection in elderly patients with appendicitis can achieve significant results.However,laparoscopic appendectomy has a higher risk of postoperative hypercoagulable states in patients,and it is necessary to take active preventive measures for patients during the perioperative period.
作者
肖卫星
周海军
周君
陈炳荣
XIAO Weixing;ZHOU Haijun;ZHOU Jun;CHEN Bingrong(The Fourth Ward of General Surgery,Jiaxing Hospital of Traditional Chinese Medicine,Jiaxing314000,China)
出处
《中国现代医生》
2021年第26期73-77,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2018PY072)
浙江省嘉兴市科技计划项目(2017AY33051)。
关键词
阑尾炎
腹腔镜
开腹手术
凝血系统
深静脉血栓
Appendicitis
Laparoscopy
Open surgery
Coagulation system
Deep vein thrombosis
