【摘要】 目的:探讨腹腔镜Miles手术在直肠癌患者中的临床效果及对患者凝血纤溶系统的影响。方法:选取2016年2月—2017年2月治疗的直肠癌患者48例作为观察对象,随机数字表分为对照组(n=24)和观察组(n=24)。对照组给予传统开腹手术治疗,观察组采用腹腔镜Miles手术治疗,统计并记录两组手术时间、淋巴结清扫数、出血量、腹部切口长度、肠功能恢复时间;采用CA7000全自动血液分析仪测定两组纤维蛋白原(FIB)、凝血活酶时间(APTT)、凝血酶原时间(PT)及血小板(PLT)水平;统计并记录两组治疗后切口感染、吻合口瘘、认知功能障碍、尿潴留、DVT发生率,比较两组临床效果及对患者凝血纤溶系统的影响。结果:两组淋巴结清扫数比较差异无统计学意义(P>0.05);观察组手术时间长于对照组(P<0.05);观察组出血量、腹部切口长度、肠功能恢复时间均短(少)于对照组(P<0.05);观察组手术后PT、APTT时间均长于对照组(P<0.05);观察组手术后FIB、PLT水平低于对照组(P<0.05);观察组手术后切口感染、吻合口瘘、认知功能障碍、尿潴留、DVT发生率均低于对照组(P<0.05)。结论:将腹腔镜Miles手术用于直肠癌患者中手术创伤较小,能改善患者凝血纤溶系统,手术安全性较高,值得推广应用。更多还原

【Abstract】 Objective:To investigate the clinical effect of laparoscopic Miles surgery in patients with rectal cancer and its effect on coagulation and fibrinolysis system.Methods:A total of 48 patients with rectal cancer who were treated from February 2016 to February 2017 were enrolled.The random number table was divided into control group(n=24) and observation group(n=24).The control group was treated with conventional open surgery.The observation group was treated with laparoscopic Miles.The operation time, lymph node dissection,blood loss,abdominal incision length and intestinal function recovery time were recorded and recorded.The CA7000 automatic blood analyzer was used to measure Two groups of fibrinogen(FIB),thromboplastin time(APTT),prothrombin time(PT) and platelet(PLT) levels;statistics and recorded post-treatment wound infection,anastomotic leakage,cognitive dysfunction,incidence of urinary retention and DVT was compared between the two groups and the effects of coagulation and fibrinolysis system.Results:There was no significant difference in the number of lymph node dissection between the two groups(P>0.05).The operation time of the observation group was longer than that of the control group(P<0.05).The amount of bleeding in the observation group,the length of the abdominal incision,and the recovery time of intestinal function were all short;the levels of PT and APTT in the observation group were longer than those in the control group(P<0.05).The levels of FIB and PLT in the observation group were lower than those in the control group(P<0.05).The incidence of wound infection,anastomotic leakage,cognitive dysfunction,urinary retention and DVT were lower in the observation group than in the control group(P<0.05).Conclusion:Laparoscopic Miles surgery is used in patients with rectal cancer.The surgical trauma is small,which can improve the coagulation and fibrinolysis system of patients.It has high safety and is worthy of popularization and application.更多还原