腹腔镜及手助腹腔镜肾切除术应激指标比较.docVIP

腹腔镜及手助腹腔镜肾切除术应激指标比较 　 作者：翟振波，张楠，金雷， 王立国， 杨力军， 张运涛， 王禾，袁建林 【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), Plt;0.05；(36.92±0.30) vs (37.10±0.50), Plt;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), Plt;0.05; (12.1±1.2) vs (14.1±3.1), Plt;0.05; (8.9±0.8) vs (10.0±4.0), Plt;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), Plt;0.05; (12.7±10.4) vs (16.8±8.0), Plt;0.05; (10.4±8.6) vs (13.4±7.2), Plt;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), Pgt;0.05; (47.3±16.2) vs (47.3±16.2), Pgt;0.05; (12.0±1.7) vs (15.0±1.5), Pgt;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. 【关键词】 腹腔镜; 肾切除术; 应激; c反应蛋白; 白细胞介素6 　　【Abstract】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), Plt;0.05；(36. 92 ±0. 30) vs (37. 10 ±0. 50), Plt;0.05］; The white 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), Plt;0.05; (12.1±1.2) vs (14.1±3.1), Plt;0.05; (8.9±0.8) vs (10.0±4.0), Plt;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), Plt;0.05; (12.7±10.4) vs (16.8±8.0), Plt;0.05; (10.4±8.6) vs (13.4±7.2), Plt;0.05］. The IL6 had no statistic difference in the 2 groups［(73.6±59.5) vs (133.0