腹腔镜手术对卵巢囊肿患者应激代谢影响.doc

腹腔镜手术对卵巢囊肿患者应激代谢影响【摘要】 目的 评估腹腔镜和开腹手术对卵巢囊肿患者机体应激及代谢的影响。方法 以随机方式分为腹腔镜组和开腹手术组。分别检测术前24 h、术后24 h和术后72 h血清中肝酶及甲状腺激素、皮质醇的改变。比较二组变化。结果 （1）手术后血皮质醇升高，但是手术后24 h皮质醇腹腔镜组较开腹手术组变化不显著，两组术后72 h都回复到术前水平。（2）腹腔镜组手术前后甲状腺相关激素反应轻、恢复快，在术后72 h又恢复术前水平。激素水平在开腹组变化较大，FT3术后72 h未达到术前水平。（3）肝酶对二组影响不大。（4）两组的手术时间和失血量基本相似。结论 腹腔镜手术较开腹手术对机体的应激及代谢的影响小，腹腔镜手术是卵巢囊肿患者有效安全损伤少的治疗方法。 【关键词】 开腹手术; 腹腔镜手术; 代谢; 应激 The study about effect on stress and metabolism for laparoscopic ovarian cyst surgery *LU Yi-xia,LE Ai-wen,WANG Zhong-hai.*Chaonan People’s Hospital of Shantou City，Shantou City 515144，China 【Abstract】 Objective To assess metabolism and body stress of laparoscopic and open surgery for ovarian cysts patient.Methods We randomly divided patients into the laparoscopic group and open surgery group. We detected serum liver enzymes and thyroid hormones, cortisol changes 24 h before operation, 24 h,72 h after surgery. The changes in two groups were compared.Results （1） The serum cortisol was elevated after 24 h after surgery. The change 24 h postoperative was not significant difference between two groups, the serum cortisol was returned to preoperative levels after 72 h postoperative. （2）The thyroid hormone before and after surgery was response to light and quick which recovered the preoperative level72h after surgery in laparoscopic group. The change in hormone levels in laparoscopic group was larger in the open surgery group, FT3 did not reach the preoperative level 72h after surgery. （3）The liver enzymes had little effect on the two groups. （4） The operative time and blood loss were similar in the two groups.Conclusion The metabolism and body stress is smaller effect on laparoscopic surgery than open surgery, laparoscopic surgery is effective、safe and less damage in patients with ovarian cysts. 【Key words】 Open surgery; Laparoscopic surgery; Metabolic; Stress 1987年3月Mouret完成了第一例腹腔镜胆囊切除术（LC），近10年在妇科领域腹腔镜飞速发展，卵巢囊肿的治疗由创伤较大的开腹手术逐渐被微创的腹腔镜手术替代。由于腹腔镜手术具有微创、外观美、恢复快等序列优点，可是腹腔镜手术对于机体代谢和应激的影响仍存有争议，因此为探讨腹腔镜