引用本文:徐 浩,郑伦辉,张居易,王毓彬.腹腔镜腹膜前疝修补术与Lichtenstein疝修补术对腹股沟疝患者凝血功能的影响[J].中国临床新医学,2020,13(1):64-66.
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腹腔镜腹膜前疝修补术与Lichtenstein疝修补术对腹股沟疝患者凝血功能的影响
徐 浩,郑伦辉,张居易,王毓彬
405400 重庆,重庆市开州区人民医院普外科
摘要:
[摘要] 目的 比较腹腔镜腹膜前疝修补术(TAPP)与Lichtenstein疝修补术治疗腹股沟疝对患者凝血功能的影响。方法 选取2017-06~2019-06收治的70例腹股沟疝患者作为研究对象,随机分为研究组和对照组,各35例。研究组采用TAPP治疗;对照组采取Lichtenstein疝修补术治疗。观察比较两组患者手术情况及围术期凝血功能指标的变化。结果 两组术前凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、D二聚体(D-D)比较差异无统计学意义(P>0.05);术后0 h、术后24 h与术前比较,两组PT和APTT显著下降,Fbg和D-D水平显著上升(P<0.05);术后0 h与术后24 h比较,两组PT、APTT、Fbg比较差异无统计学意义(P>0.05),术后两组的D-D水平比较差异有统计学意义(P<0.05),但术后24 h两组D-D水平比较差异无统计学意义(P>0.05)。研究组术后D-D水平波动更大,术后上升更高,术后24 h下降更多(P<0.05)。结论 TAPP与Lichtenstein疝修补术均使腹股沟疝患者凝血功能增强,血液处于高凝状态。TAPP可能给患者带来更严重的高凝状态,但因术后康复快,下床活动早,避免了血液瘀滞,并没有增加术后深静脉血栓风险,故TAPP值得临床推广应用。
关键词:  腹股沟疝  腹腔镜  疝修补术  凝血功能
DOI:10.3969/j.issn.1674-3806.2020.01.15
分类号:R 656.2+1
基金项目:
Effects of transabdominal preperitoneal prosthetic and Lichtenstein hernia repair on coagulation function in patients with inguinal hernia
XU Hao, ZHENG Lun-hui, ZHANG Ju-yi, et al.
Department of General Surgery, the People′s Hospital of Kaizhou District, Chongqing City, Chongqing 405400, China
Abstract:
[Abstract] Objective To compare the effects of transabdominal preperitoneal prosthetic(TAPP) and Lichtenstein hernia repair on coagulation function in patients with inguinal hernia. Methods Seventy patients with inguinal hernia admitted to our hospital from June 2017 to June 2019 were selected, and were randomly divided into study group and control group, with 35 cases in each group. The study group was treated with TAPP, while the control group was treated with Lichtenstein hernia repair. The operation results and the changes of coagulation function indicators were observed and compared between the two groups. Results There were no significant differences in prothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(Fbg)and D-dimer(D-D)between the two groups before surgery(P>0.05). Compared with those before surgery, PT and APTT decreased significantly while Fbg and D-D levels increased significantly in the two groups 0 h and 24 hours after surgery(P<0.05). There were no significant differences in PT, APTT and Fbg between the two groups 0 h and 24 hours after surgery(P>0.05). There was a significant difference in D-D level between the two groups after surgery(P<0.05). However, there was no significant difference in D-D level between the two groups 24 hours after surgery(P>0.05). The fluctuation of D-D level was greater in the study group after operation, which showed a higher increase after operation and a more decrease 24 hours after operation(P<0.05). Conclusion Both TAPP and Lichtenstein hernia repair can enhance the coagulation function of the patients with inguinal hernia, and keep blood in a hypercoagulable state. Although TAPP may bring hypercoagulable state to the patients, it does not increase the risk of deep vein thrombosisc(DVT) after operation because of quick recovery and early movement in the patients receiving TAPP. TAPP is worthy of clinical application.
Key words:  Inguinal hernia  Laparoscope  Herniorrhaphy  Coagulation function