短期减重对减肥手术后止血和血栓形成的影响

Ahmed Taha, Hasan Eroğlu, İskender Eren Demirbaş, Berkay Demir, Evren Dilektaşli
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The first-month platelet levels were significantly different from the preoperative values ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> </math> < 0.001). The prothrombin time in the first ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"> <mi>p</mi> </math> < 0.001) and third months ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"> <mi>p</mi> </math> < 0.009) was also comparable. The PTT in the first month was higher than in the preoperative period ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M4\"> <mi>p</mi> </math> < 0.011). INR in the first month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M5\"> <mi>p</mi> </math> < 0.001) was higher than that in the preoperative period and the third month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M6\"> <mi>p</mi> </math> = 0.007) value was higher than in the first month. In terms of fibrinogen levels, all parameters indicated statistical significance within each other; preoperative to the first month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M7\"> <mi>p</mi> </math> < 0.001), the first month to the third month ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M8\"> <mi>p</mi> </math> < 0.016). Third-month D-dimer levels were lower than the first month’s values ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M9\"> <mi>p</mi> </math> = 0.032). Conclusion. Thromboembolic events have crucial importance in the converse scenario of haemorrhagic diathesis during the first months of bariatric surgery. 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引用次数: 0

摘要

介绍。肥胖导致血栓和许多与减缓毛细血管流动有关的凝血问题。我们的目的是评估凝血系统减肥手术后早期快速减肥的结果。材料和方法。一项前瞻性研究招募了28名BMI为>40公斤/平方米,接受减肥手术。分析术前和术后(第1和第3个月)人口统计学指标,如年龄、性别、体重、身高、烟酒使用情况,生化指标如PLT、PT、aPTT、INR、出血时间、凝血时间、纤维蛋白原、D-二聚体、白蛋白、钙、离子钙、维生素D、甲状旁腺激素。结果。我们发现出血和血栓参数在早期减慢手术中增加。第1个月血小板水平与术前有显著差异(p <0.001)。凝血酶原时间(p <0.001)和第三个月(p <0.009)也具有可比性。术后第1个月PTT高于术前(p <0.011)。第一个月的印度卢比(p <0.001)高于术前,第3个月高于第1个月(p = 0.007)。在纤维蛋白原水平方面,各参数之间具有统计学意义;术前至第一个月(p <0.001),第一个月至第三个月(p <0.016)。第3个月d-二聚体水平低于第1个月(p = 0.032)。结论。在减肥手术的头几个月,血栓栓塞事件在出血性素质的相反情况下具有至关重要的意义。术后早期可推荐维生素支持和抗血栓药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Short-Term Weight Loss on Hemostasis and Thrombosis after Bariatric Surgery
Introduction. Obesity causes thrombophilia and many coagulation problems related to slowing the capillary flow. We aimed to evaluate rapid weight loss outcomes in the early period after bariatric surgery on the coagulation system. Materials and Method. A prospective study enrolled 28 patients with a BMI > 40 kg/m2 who underwent bariatric surgery. Preoperative and postoperative (first and third months) demographic criteria—such as age, gender, weight, height, and alcohol and tobacco use, and biochemical parameters such as PLT, PT, aPTT, INR, bleeding time, coagulation time, fibrinogen, D-dimer, albumin, calcium, ionized calcium, vitamin D, and PTH—were analyzed. Results. We found that both bleeding and thrombotic parameters increase in early-slowing surgery. The first-month platelet levels were significantly different from the preoperative values ( p < 0.001). The prothrombin time in the first ( p < 0.001) and third months ( p < 0.009) was also comparable. The PTT in the first month was higher than in the preoperative period ( p < 0.011). INR in the first month ( p < 0.001) was higher than that in the preoperative period and the third month ( p = 0.007) value was higher than in the first month. In terms of fibrinogen levels, all parameters indicated statistical significance within each other; preoperative to the first month ( p < 0.001), the first month to the third month ( p < 0.016). Third-month D-dimer levels were lower than the first month’s values ( p = 0.032). Conclusion. Thromboembolic events have crucial importance in the converse scenario of haemorrhagic diathesis during the first months of bariatric surgery. Vitamin support and antithrombotic agents may be recommended in the early postoperative period.
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来源期刊
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期刊介绍: Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.
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