腹腔镜下胃癌手术后血液高凝状态发生的监测及护理

目的分析腹腔镜下胃癌手术后高凝血状态发生的监测及护理。方法选取我院2014年9月至2016年1月期间接受腹腔镜下胃癌手术的患者86例,随机分为观察组和对照组各43例,两组手术均由同一组医师完成,给予对照组常规护理,观察组在对照组基础上根据高凝血状态监测结果给予针对性护理。通过检测术前术后凝血指标水平变化及术后并发症发生情况比较两组护理效果。结果两组术前各项凝血指标均低于正常水平且比较无统计学意义(P0.05),两组各项凝血指标在术后3 d均略有下降,但术后7 d、术后14 d均明显上升(P0.05),观察组术后7 d、术后14 d PT、a PTT、INR均显著高于对照组;观察组并发症发生率为9.30%显著低于对照组30.23%(P0.05)。结论腹腔镜下胃癌手术患者术后明显处于高凝血状态,密切监测患者凝血状态,实行针对性护理干预对改善患者高凝血状态、减少血栓等并发症的发生有重要意义。

Monitoring and Nursing Intervention of Hypercoagulable State After Laparoscopic Gastric Cancer Surgery

Objective To analyze the monitoring and nursing intervention of hypercoagulable state after laparoscopic gastric cancer surgery.Methods 86 patients who underwent laparoscopic gastric cancer surgery in our hospital between September 2014 and January 2016 were randomized into observation group and control group,43 cases in each.Both groups were operated by the same group of physicians.The control group was given routine nursing while the observation group,on the basis of the control group,was given targeted nursing according to the monitoring results of hypercoagulable state.Through detecting the changes of levels of coagulation indexes before and after operation and the incidence of postoperative complications,the nursing effect was compared between the two groups.Results Before operation,the levels of coagulation indexes in the two groups were lower than the normal level(P ＞ 0.05).The coagulation indexes decreased slightly in the two groups on the 3rd day after operation.However,on the 7th and 14th day after operation,they increased significantly(P ＜ 0.05).On the 7th and 14th day after operation,PT,aPTT and INR in observation group were significantly higher than control group;the incidence rate of complications in observation group (9.30％)was significantly lower than control group (30.23％) (P ＜ 0.05).Conclusion Patients after laparoscopic gastric cancer surgery are obviously in hypercoagulable state.Close monitoring of coagulation state and implementation of nursing intervention are of great significance in improving hypercoagulable state and reducing complications such as thrombosis.