腹腔镜联合脏器切除对机体应激反应的影响  

Impact of laparoscopic combined organ resection on stress response

作　　者：张波[1] 徐越[1] 张彬[1] 王雪清[1] 

机构地区：[1]四川省成都市第五人民医院普外科,611130

出　　处：《临床外科杂志》2014年第3期175-177,共3页Journal of Clinical Surgery

基　　金：四川省卫生厅科研课题（编号110047）

摘　　要：目的 探讨腹腔镜联合脏器切除对机体应激反应的影响.方法 选择2011年7月至2013年6月在我院成功实施腹腔镜子宫切除术（LH）或腹腔镜子宫次全切除术（LSH）联合腹腔镜胆囊切除术（LC）患者48例（联合手术组）作为观察组,随机选择同期入院单一行LH或LSH患者48例（妇科手术组）、LC女性患者48例（胆囊手术组）作为对照组.比较各组手术时间、术中出血量、麻醉清醒后视觉模拟评分（VAS评分）、肛门排气时间及住院时间;术前及术后第1、2、3天血浆超敏C反应蛋白（hs-CRP）、白细胞计数.结果 联合手术组与妇科手术组比较,手术时间、术中出血量差异无统计学意义（P＞0.05）,但与胆囊手术组比较差异有统计学意义（P＜0.05）;各组间VAS评分、肛门排气时间、住院时间、血浆hs-CRP、白细胞计数比较差异无统计学意义（P＞0.05）.结论 腹腔镜下同期联合胆囊、子宫切除并不显著增加患者机体应激反应.Objective To explore the impact of laparoscopic combined organ resection on stress response. Methods Forty-eight patients who received laparoscopic hysterectomy （LH）or laparoseopic subtotal hysterectomy （ LSH ） combined with laparoscopic choleeystectomy （ LC ） in our hospital from July 2011 to June 2013 were chosen in the combined surgery group;during the corresponding period,48 patients who received LH or LSH only were randomly chosen in the gynaecologic group, and 48 female patients who received LC only were randomly chosen in the LC group. The three groups were compared in terms of the mean operation time, the mean blood loss, Visual Analogue Scale（VAS） , the mean time to first flatus and the mean postoperative hospital stay. The authors also compared the level of serum high sensitivity C reac- tive protein（ hs-CRP） and WBC counts on the day before operation and 1,2 and 3 days after operation a- mong groups. Results There was no difference in the mean operation time or the mean blood loss between the combined surgery group and gynaecologic group（ P 〉 0.05 ）. Significant difference was showed between the combined surgery group and LC group. There was no difference in VAS, the mean time to first flatus, the mean postoperative hospital stay, the level of serum hs-CRP or WBC counts among the three groups. Conclusion Simultaneous laparoseopic excision for gallbladder and hystera does not significantly increase stress response.

关 键 词：腹腔镜 联合手术 应激反应 胆囊 子宫 

分 类 号：R608[医药卫生—外科学]