Effects Of Lapaposcopic Cholecystectctomy On The Biood Coagulation System Of Patients

Objective:At present, research on the formation of venous thrombosis (DVT) of lower extremity after surgery has been increasing gradually, but there are not enough reports on complications of laparoscopic cholecystectomy (DVT) in plateau area. The formation of deep vein thrombosis is a potential complication resulting in disability and death, which happened after laparoscopic surgery on hepatobiliary, obstetrics, Gynecology, stomach and urinary. However, the incidence of venous thrombosis varies in different reports. Therefore, this report is going to research the effect of laparoscopic cholecystectomy on coagulation system of patients in plateau region.Method:75 patients is selected as subjects who accepted gallbladder operation from 03/2014 to 08/2014 in the first affliliate hospital of baotou medical college, and they are divided into two groups based on different operation ways. There are 31 open cholecystectomy patients in the open group and 44 laparoscopic cholecystectomy patients in laparoscopic group. Index of all the patients including platelet count (PLT), prothrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT), fibrin original (FIB), D-Dimer (DD) were tested in the 1 day preoperative.24 hours and 72 hours postoperatively. Lower extremity vascular color doppler ultrasound was also examined 3 days postoperatively. After pretreatment, samples taken at different time are sent to Blood Screening Test Laboratory to test D-dimer、FIB、TT、PLT、APTT and Pt value using ELISA (enzyme linked immuno sorbent assay) and to test Color Doppler ultrasound 3 days after surgery. These index was recorded to compare surgical effect, coagulation system related indexes, the formation of lower extremity deep venous thrombosis, and the quality of life of the patients before leaving hospital between the two groups. SPSS 15.0 are used and all quantitative data is expressed as (x±s). Independent samples such as coagulation, operative time, pain score index is compared using two independent t samples. Besides, count data is expressed as a percentage. Postoperative complications and the rate of bile duct injury were tested using X square test when quasi alpha=0.05. The results are of statistical significance when P< 0.05.Results:The success rate of the two groups is of statistically significance (P>0.05). The operation time, intraoperative bleeding, postoperative anal exhaust time, borborygmus recovery time, hospitalization time of the observation group was less than that of the control group. Also, the rate of bile duct injury, postoperative pain score and intestinal adhesion rate of the observation group were lower than that of the control group, which is of statistically significance (P<0.05). Coagulation indexes of platelet count (PLT), prothrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT), fibrin original (FIB), D-Dimer (DD) tested in two groups 24 hours before surgery is not statistically significant (P> 0.05), and neither is PLT、PT、APTT、TT、FIB、DD tested 24 hours after surgery and 72 hours after surgery. Besides, the incidence of venous thrombosis after surgery in the two groups was not statistically significant (P>0.05). The quality of life in the role limited, physical pain, overall health, life and other aspects in the observation group before leaving hospital are higher than that of the control group, which is of statistically significance (P<0.05).Conclusions:Laparoscopic cholecystectomy is better than traditional open operation.because of less trauma, less bleeding, quicker recovery and less complications etc...The interaction of position and pneumoperitoneum do not have an significant effect on blood coagulation state, which can improve the quality of life of patients after operation. Therefore, laparoscopic cholecystectomy deserves to be popularized.