腹腔镜和手助腹腔镜肾切除术的应激指标比较  

Comparison of stress response between laparoscopic and hand-assisted laparoscopic nephrectomy

作　　者：翟振波[1] 张楠[1] 金雷[1] 王立国[1] 杨力军[1] 张运涛[1] 王禾[1] 袁建林[1] 

机构地区：[1]第四军医大学西京医院泌尿外科,陕西西安710033

出　　处：《第四军医大学学报》2008年第10期918-920,共3页Journal of the Fourth Military Medical University

基　　金：国家科技攻关计划项目(2004BA720A12);陕西省科技攻关计划项目[2005K12-G4(1)]

摘　　要：目的:比较后腹腔镜肾切除(LN)和手助腹腔镜肾切除术(HALN)患者的应激反应及临床意义.方法:随机选择36例LN患者和36例HAL患者进行前瞻性研究.比较两种术式术后的体温变化、肠蠕动恢复时间、白细胞计数、c-反应蛋白和白介素6的变化特点.结果:LN组的术后最高平均体温与最低平均体温均明显低于HALN组[(37.51±0.26)vs(38.20±0.41),P<0.05;(36.92±0.30)vs(37.10±0.50),P<0.05];LN组术后1,2,3 d白细胞计数低于HALN组[(14.1±1.5)vs(17.2±2.0),P<0.05;(12.1±1.2)vs(14.1±3.1),P<0.05;(8.9±0.8)vs(10.0±4.0),P<0.05];LN组术后1,2,3 d c-反应蛋白浓度变化亦较HALN组小[(7.6±2.7)vs(10.3±4.1),P<0.05;(12.7±10.4)vs(16.8±8.0),P<0.05;(10.4±8.6)vs(13.4±7.2),P<0.05];LN组术后1,2,3 d IL-6变化与HALN组相比无统计学差异[(73.6±59.5)vs(133.0±69.0),P>0.05;(47.3±16.2)vs(47.3±16.2),P>0.05;(12.0±1.7)vs(15.0±1.5),P>0.05].结论:LN组的应激反应程度明显轻于HALN组,恢复明显早于HALN组.AIM： To compare the stress response of two surgical methods： laparoscopic and hand-assisted laparoscopic nephrectomy （ LN, HALN）. METHODS ： Thirty-six LN patients and 36 HALN patients were randomly selected for a prospective study. The level of body temperature, the bowel peristalsis instauration time, the white cell count, CRP and IL -6 in 2 groups were compared between the two groups. RESULTS： The highest average body temperature and the lowest average body temperature in group LN were lower obviously than those in group HALN after the operation [（37. 51 ±0. 26） vs （38. 20 ±0. 41）, P〈0.05; （36. 92 ±0. 30）vs （37. 10±0. 50）, P〈0.05];Thewhite cell count on the first, second, third day was lower in group LN than in group HALN after operation [ （ 14. 1 ± 1.5 ） vs （ 17.2 ± 2.0）, P〈0.05; （12.1 ±1.2） vs （14. 1 ±3. 1）, P〈0.05; （ 8, 9 ± 0. 8 ） vs （ 10. 0 ± 4. 0 ）, P 〈 0.05 ]. The concentration of C-reactive protein（CRP） on the first, second, third day in group LN was lower than that in group HALN after operation [ （ 7.6 ± 2.7） vs （10. 3 ±4. 1）, P〈0.05; （12,7 ±10.4） vs （16. 8 ± 8.0）,P〈0.05; （10.4±8.6） vs （13.4±7.2）, P〈0.05]. The IL-6 had no statistic difference in the 2 groups [ （73.6 ± 59.5） vs （133.0±69.0）, P〉0.05; （47.3±16.2） vs （47.3 ±16.2）, P〉0.05; （12.0±1.7） vs （15.0±1. 5）, P 〉 0.05 ]. CONCLUSION： Stress responses in group HALN have a greater degree than those in group LN. Post-operation recovery time in group LN is earlier than that in group HALN.

关 键 词：腹腔镜 肾切除术 应激 c反-应蛋白 白细胞介素-6 

分 类 号：R699.2[医药卫生—泌尿科学]