腹膜后腹腔镜手术对上尿路病变患者血清淀粉酶及脂肪酶的影响  

Influence of retroperitoneal laparoscopic surgery on the levels of serum amylase and lipase

作　　者：赵国斌[1] 李向东[1] 唐玉红[2] 张秀梅 苏宏伟[1] 刘硕[1] 凌海滨[1] 苗文隆[1] 李凤岐[1] 

机构地区：[1]河北北方学院附属第一医院泌尿外科,河北张家口075000 [2]河北北方学院检验学院,河北张家口075000 [3]张家口市沙岭子医院急诊科,河北张家口075000

出　　处：《中华实用诊断与治疗杂志》2014年第11期1093-1094,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河北省医学科学研究重点课题计划指令项目(ZL20140296);张家口市科学技术研究与发展指导计划项目(1321124D);河北北方学院青年基金项目(Q201126)

摘　　要：目的探讨腹膜后腹腔镜手术对上尿路病变患者血清淀粉酶(serum amylase,AMS)、脂肪酶(serum lipase,LPS)的影响。方法 68例上尿路病变患者于腹膜后腹腔镜下经左侧手术入路者38例为左侧组,右侧手术入路者30例为右侧组,检测2组术前及术后1、2、4d血清AMS、LPS水平并进行比较。结果 2组术中均无胰腺损伤发生,术后AMS升高11例(左侧组10例,右侧组1例);左侧组术后1dAMS((322.4±245.5)u/L)高于术后2d((220.5±166.7)u/L)(P<0.05),且均明显高于术前((75.2±62.2)u/L)及右侧组相应时间点((82.4±76.5)、(80.3±57.6)u/L)(P<0.01),术后4d时AMS((87.3±55.2)u/L)与术前比较差异无统计学意义(P>0.05),术后2d胰腺超声检查未见异常;右侧组手术前及手术后各时间点AMS水平比较差异无统计学意义(P>0.05);手术前、后及2组间LPS水平比较差异无统计学意义(P>0.05)。结论腹膜后腹腔镜手术对LPS水平无明显影响,但左侧入路可引起AMS一过性增高。Objective To explore the influence of retroperitoneal laparoscopic urological surgery on the levels of serum amylase and serum lipase in the patients with upper urinary tract disease.Methods Sixty-eight cases of upper urinary tract disease received retroperitoneal laparoscopic surgery,in which 38 cases were performed operation via the left side and 30 cases via the right side.The changes of amylase and lipase before operation and 1,2and 4days after operation were detected and compared between two groups.Results No pancreatic injury was found in both two groups during operation.The levels of amylase increased in 11 cases after operation（10in left side group and 1in right side group）,with the incidence of 16.18%.The amylase level was（322.4±245.5）u/L on the 1st postoperative day,higher than that on the 2nd postoperative day（（220.5±166.7）u/L）in left side group（P〈0.05）and before operation（（75.2±62.2）u/L）,and higher than those on the same time points in right side group（（82.4±76.5）,（80.3±57.6）u/L）（P〈0.01）,and was（87.3±55.2）u/L on the 4th postoperative day,showing no significant difference in comparison with that before operation（P〉0.05）.Ultrasonography showed normal pancreases on the 2nd postoperative day.There was no significant difference in the amylase levels in the right side group before and after operation（P〉0.05）,and in lipase level between two groups before and after operation（P〉0.05）.Conclusion Retroperitoneal laparoscopic surgery has no significant influence on lipase level,but can increase amylase level transiently.

关 键 词：上尿路病变 腹腔镜 血清淀粉酶 血清脂肪酶 

分 类 号：R699[医药卫生—泌尿科学]