高血压患者气腹前后凝血分子标志物的变化  

Changes of molecular markers of the coagulation and fibrinolysis in patients during LC

作　　者：王浩龙[1] 计嘉军[2] 翟艳苓[2] 毛羽[3] 

机构地区：[1]北京市大兴区人民医院,北京102600 [2]首都医科大学附属北京同仁医院,北京100730 [3]北京市卫生局,北京100053

出　　处：《中国医刊》2011年第7期42-44,共3页Chinese Journal of Medicine

摘　　要：目的研究腹腔镜胆囊切除术对高血压患者术前术后凝血、纤溶系统的变化。方法将56例行腹腔镜胆囊切除术的患者分为非高血压组(31例)和高血压组(25例),分别于气腹前及气腹后测定血浆组织因子活性(TF:A)、血浆凝血酶-抗凝血酶Ⅲ复合物(TAT)、血浆组织型纤溶酶原激活物(t-PA)、血浆纤溶酶原激活物抑制物(PAI-1)。结果非高血压患者在气腹后TAT、t-PA和PAI-1较气腹前增高有统计学意义,高血压患者组在气腹后TAT和PAI-1较气腹前增高有显著统计学意义。结论高血压患者在腹腔镜胆囊切除术中存在高凝状态,提示高血压患者行腹腔镜胆囊切除术应采取抗凝措施,以预防术后静脉血栓。Objective To investigate the changes of coagulation and fibrinolysis in patients during laparoscopic cholecystectomy （LC）. Methods Fifty-six patients who had undergone LC were di-vided into non-essential hypertension group （31cases） and with essential hypertension group （25cases）. Blood sam-pies were collected before and after pneumoperitoneum. The following plasma molecular markers were measured： tissue factor activity （TF：A）, thrombin- antithrombin III complexes （TAT）, tissue-typeplasminogen activator （t-PA） and plasminogen activator inhibitor-1 （ PAI-1 ）. Results In non-essential hypertension group （ post-pneumoperitoneum）, TAT,t-PA and PAI-lwere signifi- cantly increased. Conclusion hypertension group （ post-pneumoperitoneum）, PAI-1 and TAT were significantly increased. Conclusion The increase in the coagulation activity and the decrease in the fibrinolytic activity exist in the patients with essential hypertension during LC. It seems to signify much thrombotic risk for them following LC. This study suggests that thromboembolism prophylaxis should be considered in essential hypertension patients following LC.

关 键 词：胆囊切除术 腹腔镜 纤维蛋白溶解 凝血酶 

分 类 号：R657.4[医药卫生—外科学]