Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass
Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass
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DOI：
10.1001/archsurg.136.8.909
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发表时间：
2001-08-01
影响因子：
--
通讯作者：
Wolfe, BM
中科院分区：
文献类型：
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作者：
Nguyen, NT;Owings, JT;Wolfe, BM
假设：腹腔镜胃旁路术（GBP）诱导术后高凝状态，与开放胃旁路术相似或降低。单位：大学医院。患者：1999年5月至2000年6月，70例患者随机分配到腹腔镜下（n=36）或开放式（n=34） GBP。深静脉血栓（DVT）预防包括抗栓塞长袜和顺序气动压缩装置。主要观察指标：纤溶酶原、凝血酶-抗凝血酶复合物（TAT）、凝血酶原片段1.2 （F1.2）、纤维蛋白原、d -二聚体、抗凝血酶III （AT）和蛋白C水平分别于基线和术后1、24、48和72小时测定。术前及术后第3天至第5天进行双下肢静脉检查。结果：两组患者年龄、体重、体质指数相近。腹腔镜和开放式GBP后，纤溶酶原水平降低，TAT、F1.2和纤维蛋白原水平升高。这些水平在两组之间没有显著差异。两组d -二聚体水平均升高，但开腹bp术后d -二聚体水平明显高于腹腔镜bp术后(P
Hypothesis: Laparoscopic gastric bypass (GBP) induces a postoperative hypercoagulable state that is similar or reduced compared with open GBP.Setting: University hospital.Patients: Between May 1999 and June 2000, 70 patients were randomly assigned to laparoscopic (n=36) or open (n=34) GBP. Deep venous thrombosis (DVT) prophylaxis consisted of antiembolism stockings and sequential pneumatic compression devices.Main Outcome Measures: Plasminogen, thrombin-antithrombin complex (TAT), prothrombin fragment 1.2 (F1.2), fibrinogen, D-dimer, antithrombin III (AT), and protein C levels were measured at baseline and at 1, 24, 48, and 72 hours postoperatively. A venous duplex examination of both lower extremities was performed preoperatively and between the third and fifth day postoperatively.Results: The 2 groups were similar in age, weight, and body mass index. Plasminogen levels decreased, and TAT, F1.2, and fibrinogen levels increased after laparoscopic and open GBP. There was no significant difference in these levels between groups. D-dimer levels increased in both groups, but the levels were significantly higher after open GBP than after laparoscopic GBP (P