腹腔镜胆囊切除术后患者血液高凝状态形成影响因素的前瞻性队列研究

发布时间：2018-09-03 08:00

【摘要】：目的:探讨影响腹腔镜胆囊切除术后患者血液高凝状态形成的影响因素。方法:前瞻性选择2012年1月—2015年12月接受腹腔镜胆囊切除术治疗的患者108例为研究对象,比较术后24 h发生血液高凝状态与未发生血液高凝状态的患者间相关临床因素的差异,分析术后血液高凝状态形成的影响因素。结果:108例腹腔镜胆囊切除术患者中,32例(29.63%)发生血液高凝状态。与未发生血液高凝状态的患者比较,发生血液高凝状态的患者有高血脂病史的比例与术前收缩压、纤维蛋白原(Fbg)、D-二聚体(D-D)、血小板计数(PLT)、凝血酶原片段(F1+F2)、转铁蛋白(Trf)、α-酸性糖蛋白(Orso)、C-反应蛋白(CRP)、白介素6(IL-6)、低密度脂蛋白胆固醇(LDL-C)水平明显增高,而高密度脂蛋白胆固醇(HDL-C)水平明显降低(均P0.05)。单因素与多因素Logistic回归分析结果显示,有高血脂病史、Fbg≥3.95 g/L、D-D≥100.00μg/L、PLT≥228.00×10~9/L、F1+F2≥0.16 nmol/L、Trf≥2.15 g/L、Orso≥0.85 g/L、CRP≥1.50 mg/L、IL-6≥1.50 pg/mL、LDL-C≥2.85 mg/dL是腹腔镜胆囊切除术后患者血液高凝状态形成的独立危险性因素(均P0.05)。结论:对于行腹腔镜胆囊切除术患者,如存在上述因素应注意血液高凝状态的发生。
[Abstract]:Objective: to investigate the influencing factors of blood hypercoagulability after laparoscopic cholecystectomy (LC). Methods: 108 patients undergoing laparoscopic cholecystectomy from January 2012 to December 2015 were prospectively selected. To compare the difference of clinical factors between patients with hypercoagulability and those without hypercoagulability at 24 hours after operation, and analyze the influencing factors of blood hypercoagulability after operation. Results among 108 cases of laparoscopic cholecystectomy, 32 cases (29.63%) developed hypercoagulability. Compared with patients without hypercoagulability, patients with hypercoagulability had a history of hyperlipidemia and systolic blood pressure before operation. The levels of fibrinogen (Fbg) D-dimer (D-D), platelet count, (PLT), prothrombin fragment (F _ 1 F _ 2), transferrin (Trf), 伪 -acid glycoprotein (Orso) (Orso) (CRP), interleukin 6 (IL-6) and low density lipoprotein cholesterol (LDL-C) were significantly increased. The level of high density lipoprotein cholesterol (HDL-C) was significantly decreased (P0.05). Univariate and multivariate Logistic regression analysis showed that, With a history of hyperlipidemia, FBG 鈮，

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