喉癌、喉咽癌患者围手术期血浆D-二聚体的动态变化及临床意义
发布时间：2018-09-12 06:20
【摘要】： 目的：通过研究喉癌、喉咽癌患者围手术期血浆D-二聚体的动态变化规律来评价血浆D-二聚体对早期排除肺栓塞的价值。 方法：对42例喉癌、喉咽癌患者的术前及术后第1、3、7、10天血浆D-二聚体水平进行分析。其中包括32例喉癌,10例喉咽癌。均为男性,平均年龄(59.7±8.0)岁,术前均无颈部手术史及放疗史；喉癌组中包括声门上型3例,声门型29例；Ⅰ期4例,Ⅱ期13例,Ⅲ期10例，，Ⅳ期5例；T1N0M04例、T2N0M013例、T2N1M02例、T3N0M05例、T3N1M03例、T4N1M02例、T4N2M02例、T4N3M01例；喉咽癌组患者10例,包括Ⅲ期4例,Ⅳ期6例,T2N1M02例、T2N2M01例、T3N0M01例、T3N1M01例、T3N2M03例、T4N2M02例。对照组18例,包括11例声带息肉患者,7例会1厌囊肿患者,平均年龄(53.5±7.5)岁。 喉癌、喉咽癌组于术前、术后第1、3、7、10天清晨采集空腹外周静脉血,于1小时内室温转运并检测血浆D-二聚体。对照组只采集术前外周静脉血,余与喉癌、喉咽癌组相同。 结果：对照组与喉癌、喉咽癌组术前血浆D-二聚体水平存在差异,有统计学意义(t=1.663,P=0.017＜0.05)。喉癌、喉咽癌组中,喉癌与喉咽癌患者术前血浆D-二聚体水平差异没有统计学意义(t=1.036，P=0.110.05)；喉癌、喉咽癌组术后血浆D-二聚体明显升高,与术前相比较,差异有统计学意义(q=3.3917-7.4354,P0.05-0.01)；合并心血管系统疾病患者与不合并心血管系统疾病的患者相比,术前、术后第7天及术后第10天血浆D-二聚体水平差异存在统计学意义(t=0.376-3.023,P=0.000-0.050≤0.05)；合并糖尿病患者组与不合并糖尿病的患者组相比,术前、术后第1天、术后第10天血浆D-二聚体水平存在统计学差异(t=1.247-1.725,P=0.005-0.009＜0.05)；该组是否同期进行颈清扫术对术后血浆D-二聚体水平无明显影响；是否同时有颈淋巴结转移对血浆D-二聚体水平无影响；Ⅰ、Ⅱ期喉癌、喉咽癌患者术后第7天血浆D-二聚体水平高于Ⅲ、Ⅳ期患者,差异有统计学意义(t=0.797,P=0.047＜0.05)。所有患者术前D-二聚体水平均与年龄存在相关。 结论：①喉癌、喉咽癌患者术前血浆D-二聚体水平增高；②喉癌、喉咽癌患者术后第1-10天血浆D-二聚体水平较术前进一步增高,血浆D-二聚体检测可作为喉癌、喉咽癌患者术后可疑肺栓塞患者的筛查手段；③合并心血管疾病、糖尿病的喉癌、喉咽癌患者手术前后血浆D-二聚体水平进一步增高。
[Abstract]:Objective: To evaluate the value of plasma D-dimer in early exclusion of pulmonary embolism by studying the dynamic changes of plasma D-dimer in patients with laryngeal and laryngopharyngeal carcinoma during perioperative period.
Methods: The plasma D-dimer levels of 42 patients with laryngeal cancer and laryngopharyngeal cancer were analyzed before operation and on the 1st, 3rd, 7th and 10th day after operation, including 32 patients with laryngeal cancer and 10 patients with laryngopharyngeal cancer. There were 10 cases of stage III, 10 cases of stage III, and 5 cases of stage IV; 10 cases of stage III, 10 cases of stage III, 10 cases of stage III, 6 cases of stage IV, 6 cases of stage T2N1M02, 2 cases of T2N0M02, 13 cases of T1N0M01, 13 cases of T2N1M02, 23 cases of T2N1M02, T3NN2M02, T3N1M03 cases of T3N1M03, T4NN2M02 cases of T4N2M02, T4N2M02 cases of T4N2M02, T4N3N3N2M02 cases, T4N2M02 cases of patients of laryand pharynpharynpharynpharyncarcinoma, including 4 cases of stage III, 6 cases of stage IV, 6 cases of stage IV, 6 cases of bursa The average age of the patients was (53.5 + 7.5) years.
The fasting peripheral venous blood was collected before operation, 1,3,7,10 days after operation in the laryngopharyngeal cancer group, and transported at room temperature within 1 hour to detect plasma D-dimer.
Results: There were significant differences in plasma D-dimer levels between the control group and the laryngopharyngeal cancer group (t = 1.663, P = 0.017 < 0.05). There was no significant difference in plasma D-dimer levels between the laryngopharyngeal cancer group and the laryngopharyngeal cancer group (t = 1.036, P = 0.110.05). The levels of plasma D-dimer were significantly higher in patients with cardiovascular diseases than those without cardiovascular diseases before operation, 7 days after operation and 10 days after operation (t = 0.376-3.023, P = 0.000-0.050 < 0.05). There were significant differences in plasma D-dimer levels between the patients with urinary disease and those without diabetes mellitus before operation, on the first day after operation and on the tenth day after operation (t = 1.247-1.725, P = 0.005-0.009 < 0.05). Plasma D-dimer levels were not affected; D-dimer levels in patients with stage I, II laryngopharyngeal carcinoma were higher than those in stage III and IV on the 7th day after surgery (t = 0.797, P = 0.047 < 0.05). Preoperative D-dimer levels were correlated with age in all patients.
Conclusion: The plasma D-dimer levels in patients with laryngopharyngeal carcinoma and laryngopharyngeal carcinoma before operation are higher than those before operation. The plasma D-dimer levels in patients with laryngopharyngeal carcinoma and laryngopharyngeal carcinoma after operation are further higher than those before operation. The level of plasma D- two dimer in laryngeal and hypopharyngeal cancer patients increased further before and after operation.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.6
本文编号：2238160
[Abstract]:Objective: To evaluate the value of plasma D-dimer in early exclusion of pulmonary embolism by studying the dynamic changes of plasma D-dimer in patients with laryngeal and laryngopharyngeal carcinoma during perioperative period.
Methods: The plasma D-dimer levels of 42 patients with laryngeal cancer and laryngopharyngeal cancer were analyzed before operation and on the 1st, 3rd, 7th and 10th day after operation, including 32 patients with laryngeal cancer and 10 patients with laryngopharyngeal cancer. There were 10 cases of stage III, 10 cases of stage III, and 5 cases of stage IV; 10 cases of stage III, 10 cases of stage III, 10 cases of stage III, 6 cases of stage IV, 6 cases of stage T2N1M02, 2 cases of T2N0M02, 13 cases of T1N0M01, 13 cases of T2N1M02, 23 cases of T2N1M02, T3NN2M02, T3N1M03 cases of T3N1M03, T4NN2M02 cases of T4N2M02, T4N2M02 cases of T4N2M02, T4N3N3N2M02 cases, T4N2M02 cases of patients of laryand pharynpharynpharynpharyncarcinoma, including 4 cases of stage III, 6 cases of stage IV, 6 cases of stage IV, 6 cases of bursa The average age of the patients was (53.5 + 7.5) years.
The fasting peripheral venous blood was collected before operation, 1,3,7,10 days after operation in the laryngopharyngeal cancer group, and transported at room temperature within 1 hour to detect plasma D-dimer.
Results: There were significant differences in plasma D-dimer levels between the control group and the laryngopharyngeal cancer group (t = 1.663, P = 0.017 < 0.05). There was no significant difference in plasma D-dimer levels between the laryngopharyngeal cancer group and the laryngopharyngeal cancer group (t = 1.036, P = 0.110.05). The levels of plasma D-dimer were significantly higher in patients with cardiovascular diseases than those without cardiovascular diseases before operation, 7 days after operation and 10 days after operation (t = 0.376-3.023, P = 0.000-0.050 < 0.05). There were significant differences in plasma D-dimer levels between the patients with urinary disease and those without diabetes mellitus before operation, on the first day after operation and on the tenth day after operation (t = 1.247-1.725, P = 0.005-0.009 < 0.05). Plasma D-dimer levels were not affected; D-dimer levels in patients with stage I, II laryngopharyngeal carcinoma were higher than those in stage III and IV on the 7th day after surgery (t = 0.797, P = 0.047 < 0.05). Preoperative D-dimer levels were correlated with age in all patients.
Conclusion: The plasma D-dimer levels in patients with laryngopharyngeal carcinoma and laryngopharyngeal carcinoma before operation are higher than those before operation. The plasma D-dimer levels in patients with laryngopharyngeal carcinoma and laryngopharyngeal carcinoma after operation are further higher than those before operation. The level of plasma D- two dimer in laryngeal and hypopharyngeal cancer patients increased further before and after operation.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.6
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