| Objective: To investigate the changes of coagulation and fibrinolysis in patients during LC,LARRCC and ORRCC.Methods: Forty-five patients who had undergone LC, LARRCC and ORRCC were elected randomly. They were divided into LC group(15 cases), LARRCC group(15 cases) and ORRCC group(15 cases). Venous blood samples were collected in LC group at three points: before operation,0 and 30 min after IAP 15mmHg in operation. Venous blood samples were collected in LARRCC group at four points: before operation,0,30and 60 min after IAP 12mmHg in operation. Venous blood samples were collected in ORRCC group at four points: before operation,0,30and 60 min after start of operation. The fllowing items were measured: prothrombin time(PT),activated partial thrombolastin time(APTT),fibrinogen(Fg) and plasma protamine paracoagulation test(3P test).Results: In LC group, PT,APTT and Fg were not significantly increased or decreased(P>0.05).In LARRCC group and ORRCC group, PT and APTT were not significantly increased(P<0.01), but Fg was significantly decreased(P<0.05).In operation, changes of PT,APTT and Fg were more significant during LARRCC than during ORRCC(P<0.01), changes of PT and APTT were more significant during LARRCC than during LC(P<0.01),but changes of Fg were not significant(P>0.05).All 3P tests were negative.Conclusion: The coagulation and fibrinolysis in patients were not changed significantly during LC, but changed significantly during LARRCC and ORRCC. Furthermore, changes were more significant during LARRCC than during ORRCC, and than during LC. It indicates that CO2 pneumoperitoneum maybe one of all factors which cause the injured surface seeping blood prolonged. With the development of operative time, CO2 pneumoperitoneum can deepen blood seeping. The effects of CO2 pneumoperitoneum on the coagulation are more obvious than the fibrinolysis. Some measures must be adopted to prevent excessive seeping blood during laparoscopic surgery. |
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