The Change in Coagulation and Fibrinolysis System after Laparoscopic Hysterectomy Operation

Objective: To compare and analyze the effects of laparoscopic surgery and laparotomy for coagulation system in patients.Methods: Seventy-five hysterectomy patients were randomly divided into the laparoscopic surgery group with 38 and laparotomy surgery group with 37.Blood coagulation method was used to determine the plasm prothrombin time(PT),active partial thromboplastic time(APPT),thrombin time(TT) and fibrinogen(FIB);and enzyme linked immunosorbent assay(ELISA) was used to measure the value of D-Dimer in blood at 24 hours before,24 and 48 hours after operation.Use automated bold cell technology to analyze platelet.Results: ①There were no significant differences between the laparoscopic surgery and laparotomy surgery groups of the contents of PT,APPT,TT,FIB,PLT and D-D in blood at 24 hours before and 48 hours after operation(P0.05).②The contents of PT and APTT decreased 24 hours and 48 hours after operation,but there were no significant differences between the laparoscopic surgery and laparotomy surgery groups(P0.05).However,there were significant differences between the results of 24 hours before and 24 and 48 hours after operation(P0.05).③ There were no significant differences between the laparoscopic surgery and laparotomy surgery groups of the content of TT and PLT at 24 hours before and 24 hours after operation(P0.05).④ The content of both FIB and D-D increased at 24 hours after operation,and this differs significantly from the content before operation(P0.05).However,there were no significant differences between the laparoscopic surgery and laparotomy surgery groups(P0.05).Conclusion: The establishment of a special carbon dioxide pneumoperitoneum,the low head and high hips bladder lithotomy position,and general anesthesia in laparoscopic hysterectomy,lead to the change of patient's hemodynamic,which slow down the speed of blood flow.This effect is the same as the effect in laparotomy surgery,which increases in the blood of patients showing hypercoagulable state and increase the risk of deep venous thrombosis.So we should highly care about laparoscopic patients associated with high risk factors of thrombosis,guard against the occurrence of thrombosis.