腹腔镜胰十二指肠切除术与开腹胰十二指肠切除术对机体应激程度对比分析  

Comparative analysis on systemic stress degrees induced by laparoscopic and open pancreaticoduodenectomy

作　　者：陈小鹏[1] 刘永永[1] 樊勇[1] 王跃斌[1] 陈罗飞 王琛[1] 

机构地区：[1]兰州大学第二医院普外四科,甘肃兰州730030

出　　处：《现代医药卫生》2016年第19期2963-2965,共3页Journal of Modern Medicine & Health

摘　　要：目的比较腹腔镜胰十二指肠切除术(LPD)与开腹胰十二指肠切除术(OPD)对患者机体应激程度变化的影响,以期为临床应用提供参考依据。方法回顾性分析该科2014年10月至2016年4月收治的48例行胰十二指肠切术患者的临床资料。将24例行LPD治疗的患者作为LPD组,24例行OPD治疗的患者作为OPD组。分别测定并对比分析手术前后各时间点两组患者血清应激激素(皮质醇、肾上腺素、去甲肾上腺素、血管紧张素Ⅱ)水平,血清氧化应激指标(活性氧、超氧化物歧化酶、谷胱甘肽过氧化物酶、总抗氧化能力)变化情况。结果两组患者术前1 d血清应激激素水平及氧化应激指标检测结果比较,差异均无统计学意义(P>0.05),而术后不同时间点LPD组各指标检测结果均明显优于OPD组,差异均有统计学意义(P<0.05)。结论与传统OPD比较,LPD对患者机体应激程度的影响更小,更有利于术后患者机体的恢复。Objective To compare the influences of laparoscopic pancreatieoduodenectomy （LPD） and open pancre aticoduodenectomy （OPD） on the change of systemic stress degree so as to provide a basis for its clinical application. Methods The clinical data of 48 patients undergoing panereaticoduodeneetomy in our department from October 2014 to April 2016 were retrospectively analyzed, in which 24 cases of LPD served as the LPD group and 24 cases of OPD as the OPD group. The serum stress hormones （cortisol, adrenaline, noradrenaline, augiotensin II ） and oxidative stress indexes （reactive oxygen, superoxide dismutase, glutathion peroxidase and total antioxidant capacity） levels at various time points before and after operation were detected and compared between the two groups. Results There were no statistical differences in detection indexes of serum stress hormones and oxidative stress indexes on preoperative 1 d between the two groups （P〉0.05）, while which at different postoperative time points in the LPD group were significantly higher than those in the OPD group, and the differences were statistically significant（P〈 0.05）. Conclusion Compared with the conventional OPD,LPD has less impact on the systemic stress degree and is more conducive to the patient＇s postoperative recovery.

关 键 词：胰十二指肠切除术 腹腔镜检查 机体应激 血清应激激素 血清氧化应激指标 

分 类 号：R657.5[医药卫生—外科学]