文档介绍：holecystectomy腹腔镜胆囊切除术INRInternationalnormalizedratio国际标准化比率APTTActivatedpartialthromboplatin部分凝血活酶时间timeFIBFibrinogen纤维蛋白原D-DD-dimerD-二聚体-5-石河子大学医学院硕士学位论文摘要目的探讨不同气腹压力对LC手术病人的凝血-纤溶指标的影响。方法将60例行LC手术的病人随机分为三组,每组20例,对应气腹压力7mmHg、10mmHg、13mmHg。分别于术前24h、术后1h、术后24h,检测凝血酶原时间(PT)、国际标准化比率(INR)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)并进行组内和组间比较。结果三组间比较差异无统计学意义(P>),组内比较,7mmHg组FIB术前与术后1h差异有统计学意义(P<),与术后24h差异有显著性意义(P<);D-D术前与术后1h、24h差异有显著统计学意义(P<);10mmHg组PT术前与术后1h差异有统计学意义(P<),FIB、D-D术前与术后1h、24h差异有显著统计学意义(P<);13mmHg组PT术前与术后1h、APTT术前与术后1h、24h及FIB术前与术后24h的差异有统计学意义(P<),PT、D-D、INR术前与术后24h差异有显著统计学意义(P<)。结论各气腹压力下的LC手术均可引起患者术后凝血-纤溶指标的变化,形成高凝状态,随着压力增高,影响的指标增多,故在不影响操作的情况下,尽量选择低气腹压力,以预防血栓性疾病的发生。关键词气腹压力;腹腔镜;胆囊切除术;凝血;纤维蛋白溶解-6-,20casesineachgroup,thecorrespondingpneumoperitoneumpressure7mmHg,10mmHg,,1haftersurgery,postoperative24h,detectionofprothrombintime(PT),theinternationalnormalizedratio(INR),activatedpartialthromboplastintime(APTT),fibrinogen(FIB),D-twodimer(D-D)(P>),isinthegroup,7mmHgFIBpreoperativeandpostoperativegroup1hdifferencewasstatisticallysignificant(P<),andthe24hsignificantdifference(P<);D-Dpreoperativeandpostoperative1h,24hdifferencestatisticalsignificance(P<);10mmHgpreoperativeandpostoperativegroupPT1hdifferencewasstatisticallysignificant(P<),FIB,D-Dpreoperativeandpostoperative1h,24hdifferencestatisticalsignificance(P<);13mmHgpreoperativeandpostoperativegroupPT1h,APTTpreoperativeandpostoperative1h,24handpreoperativeandpostoperativeFIB24hdifferencewasstatisticallysignificant(P<),PT,D-D,INRpreoperativeandpostoperative24hdifferencestatisticallysignificant(P<).ConclusionThepneumoperitoneumpressureundertheLCoperationcancausepatientstopo