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目的对比分析腹腔镜手术与传统开腹手术治疗胃肠肿瘤的临床疗效及对患者血凝状态的影响。方法 154例胃肠肿瘤患者,随机分为观察组和对照组,每组77例。对照组采用传统开腹手术进行治疗,观察组采用腹腔镜手术进行治疗。对比两组患者的临床效果、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)指标等。结果观察组手术时间短于对照组、术中出血量少于对照组、排气时间短于对照组,并发症发生率低于对照组,差异均具有统计学意义(t=21.442、43.149、35.864,χ~2=9.606,P<0.05)。术前,两组患者的PT、APTT对比,差异均无统计学意义(P>0.05);术后24 h,两组患者的PT均较本组术前降低,且观察组降低程度优于对照组,差异均具有统计学意义(P<0.05);术后24 h,两组患者的APTT均较本组术前降低,且观察组降低程度优于对照组,但差异均无统计学意义(P>0.05)。结论对于胃肠肿瘤患者,采用腹腔镜手术在创伤性及并发症方面优于开腹手术,但在血凝方面,两种治疗方法均出现高凝状态,且腹腔镜方法较为明显;在临床实践中应根据患者的身体状态选择合适的治疗方法。
Objective To compare and analyze the clinical efficacy of laparoscopic surgery and conventional laparotomy in the treatment of gastrointestinal neoplasms and its effect on the patients’ blood coagulation status. Methods 154 patients with gastrointestinal tumors were randomly divided into observation group and control group, 77 cases in each group. The control group was treated by conventional laparotomy, while the observation group was treated by laparoscopic surgery. The clinical effects, active partial thromboplastin time (APTT) and prothrombin time (PT) were compared between the two groups. Results The operation time of the observation group was shorter than that of the control group. The bleeding volume during the operation was shorter than that of the control group, and the exhaust time was shorter than that of the control group. The incidence of complications was lower than that of the control group (t = 21.442, 43.149, 35.864 , χ ~ 2 = 9.606, P <0.05). Before operation, there was no significant difference in the PT and APTT between the two groups (P> 0.05). At 24 hours after operation, the PT in both groups decreased compared with preoperative, and the reduction in observation group was better than that in control group (P <0.05). The APTT of both groups was significantly lower than that of the control group 24 h after operation, and the reduction in the observation group was better than that of the control group (P <0.05). However, the differences were not statistically significant P> 0.05). Conclusions In patients with gastrointestinal tumors, laparoscopic surgery is superior to laparotomy in terms of traumatic complications. However, in the area of hemagglutination, both of the two methods have hypercoagulable state and the laparoscopic method is more obvious. In clinical practice Should be based on the patient’s body state to choose the appropriate treatment.