不同术式的胰十二指肠切除术患者术后早期症状性血栓发生的差异分析  

Analysis on the differences of early postoperative symptomatic thrombosis in patients undergoing different pancreaticoduodenectomy surgical procedures

作　　者：宋丹萍[1] 孙婷[1] 刘玮楠[1] Song Danping;Sun Ting;Liu Weinan(No.1 Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院基本外科一病房,北京100730

出　　处：《中华现代护理杂志》2023年第19期2598-2601,共4页Chinese Journal of Modern Nursing

摘　　要：目的 探讨不同术式对胰十二指肠切除患者术后早期症状性血栓发生的影响.方法 2016年9月-2018年6月,采用便利抽样法选取中国医学科学院北京协和医院的111例行胰十二指肠切除术的患者为研究对象,按照术式将其分为腹腔镜组(47例)及开腹组(64例).比较两组术毕即刻及术后第1、2、3、7天的D-二聚体值及术后早期症状性血栓的发生情况.结果 重复测量方差分析结果显示,两组术毕即刻及术后第1、2、3、7天D-二聚体值比较存在组间、时间效应,差异均有统计学意义(P<0.05).两组症状性血栓发生情况比较差异无统计学意义(P=0.62).结论 胰十二指肠切除术后早期症状性血栓的发生风险持续增高,腹腔镜在改善胰十二指肠切除术后早期症状性血栓风险方面无明显优势.Objective To explore the effect of different surgical procedures on early postoperative symptomatic thrombosis in patients undergoing pancreaticoduodenectomy.Methods From September 2016 to June 2018,111 patients undergoing pancreaticoduodenectomy in Peking Union Medical College Hospital,Chinese Academy of Medical Sciences were selected as the research objects by convenience sampling method,and were divided into the laparoscopic group(n=47)and the laparotomic group(n=64).The levels of D-dimer immediately after surgery and on the first,second,third,and seventh day after surgery and the occurrence of early postoperative symptomatic thrombus were compared between the two groups.Results Repeated measures analysis of variance showed that there were between-group and time effects in the comparison of D-dimer immediately after surgery and on the first,second,third,and seventh day after surgery between the two groups,and the differences were statistically significant(P<0.05).There was no significant difference in the occurrence of symptomatic thrombosis between the two groups(P=0.62).Conclusions The risk of early symptomatic thrombosis after pancreaticoduodenectomy gradually increases,and laparoscopy had no significant advantage in reducing the risk of early symptomatic thrombosis after pancreaticoduodenectomy.

关 键 词：静脉血栓形成 腹腔镜 胰十二指肠切除术 D-二聚体 

分 类 号：R657.5[医药卫生—外科学]