妇科腹腔镜手术和开放性手术对术后深静脉血栓形成的影响  

A Study of the Influence of Gynecology Laparoscopic Surgery and Open Surgery to Postoperative Deep Vein Thrombosis

作　　者：苏润霞[1] 黄俊彦[1] 梁月娥[1] 

机构地区：[1]广东省妇幼保健院,广州市510010

出　　处：《中国病案》2013年第3期69-70,共2页Chinese Medical Record

摘　　要：目的探讨妇科腹腔镜手术和开放性手术对术后深静脉血栓形成的影响。方法本院收治的200例妇科手术患者作为研究对象,分为观察组和对照组,每组均为100例。两组均为全身麻醉,对照组患者采用传统开放性手术,观察组患者采用腹腔镜手术。统计两组术后0.5小时的股静脉流速以及凝血功能指标,包括PT、D-D和APTT,以及术后3个月DVT发生率。结果对照组PT,APTT和股静脉流速均显著大于观察组,D-D和深静脉血栓形成发生率显著小于观察组(t=9.172,P<0.01;t=4.972,P<0.01;t=8.173,P<0.01;t=8.591,P<0.01;χ2=4.137,P<0.05)。结论 对于腹腔镜手术患者,应该严格筛选病例,并在围手术期间采取相应的预防DVT的措施,术后严密监测。可采用凝血功能指标和B超联合监测,从而提高评估DVT风险的可靠性,减少DVT发生率。Objective To discuss the influence of gynecology laparoscopic surgery and open surgery to postoperative deep vein thrombosis. Methods A total of 200 cases of patients with gynecological surgery are divided into the observation group and the control group, each group has 100 eases and are general anesthesia. Control group were treated by traditional open surgery. The observation group were treated by laparoscopic surgery. Count femoral vein flow velocity and coagulation blood function indexes 0.5 hours after operation which including PT,D - D and APTT, and DVT occurrence rate of 3 months after operation. Results The PT, APTT and femoral vein flow velocity of the control group are significantly greater than that of the observation groupand the D- D and DVT occurrence rate are significantly greater than that of the observation group（ t = 9. 172, P 〈 0.01 ; t = 4. 972, P 〈 0.01 ; t = 8. 173, P 〈 0.01 ; t = 8. 591, P 〈 0.01 ; Z 2 = 4. 137, P 〈 0.05）. Conclusion Laparoseopic surgery cases should be strictly selected. We should take corresponding measures to prevent DVT during peri - operative period and monitor it closely after operation. We can use coagulation blood function indexes and B - ultrasonography to improve the reliability of the risk assessment of DVT, reduce the incidence of DVT.

关 键 词：妇科 腹腔镜手术 开放性手术 深静脉血栓形成 

分 类 号：R713[医药卫生—妇产科学]