用二氧化碳 (CO2) 进行 laparoscopic 胆囊切除术的患者的凝血概况变化的评估 Pneumoperitoneum
Aravind Kumar1, Santhaseelan R G1, Barathi Raja Kuppusami1
1General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.
Cureus
|November 10, 2025
概括
在腹腔镜胆囊切除术期间的二氧化碳肺膜可能会诱导轻度高凝血状态. 这种情况,以较短的凝血时间和增加的D-二次体表明,在高风险患者中需要谨慎.
科学领域:
- 手术创新 在外科创新.
- 凝血科学 凝血科学
- 最少侵入性的手术
背景情况:
- 腹腔镜胆囊切除术是一种常见的胆囊切除手术.
- 二氧化碳 (CO2) 肺膜对于这一过程至关重要.
- 二氧化碳注入可能会影响血液凝固.
研究的目的:
- 为了研究二氧化碳肺膜对凝血参数的影响.
- 为了评估腹腔镜胆囊切除术期间血液凝固的变化.
主要方法:
- 在81名接受选择性腹腔镜胆囊切除术的患者 (18-60岁) 上进行了前性观察性研究.
- 手术前和后采集的血液样本 (6小时后肺上皮瘤).
- 对D-二聚体,凝血概况和国际规范比率 (INR) 的分析.
主要成果:
- 手术后的前列血时间 (PT) 和激活的局部血栓形成时间 (aPTT) 呈现下降趋势,表明凝血速度更快.
- 国际正常化比率 (INR) 和D-二次体水平在手术后显著增加.
- 这些发现表明由CO2引发的促血凝固状态.
结论:
- 使用CO2肺膜进行 laparoscopic胆囊切除术会诱导一种轻微的,亚临床的高凝血状态.
- 观察到凝血时间缩短和纤维素降解产物增加.
- 由于潜在的血栓形成,高风险患者可能需要预防.
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