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不同术式对子宫切除术后患者机体应激的影响

         

摘要

目的:观察腹腔镜辅助下阴式子宫切除术对患者机体应激的影响。方法:选取我院收治的子宫良性疾病需行择期手术治疗的患者100例,其中采用腹式及腹腔镜辅助下阴式子宫切除术治疗各50例,观察两组患者手术前及手术后24h、48h白介素-6(IL -6)、C反应蛋白( CRP )、白细胞计数( WBC)、血清皮质醇水平变化。结果:两组术后24、48h时WBC均显著高于术前( P<0.05);经腹组术后24h、48h时WBC显著高于经阴组( P<0.05);经阴组患者术后24h血清总皮质醇与术前比较无统计学差异( P>0.05),术后48h血清总皮质醇较术前及术后24h显著升高( P<0.05);经腹组术后24、48h血清总皮质醇水平均较术前显著升高(P<0.05),且术后各时间点血清总皮质醇水平均显著高于经阴组( P<0.05);两组术后24h时IL-6、CRP水平较术前显著升高( P<0.05),术后48h时IL-6、CRP 水平较术后24h显著降低( P<0.05),但仍显著高于术前( P<0.05);经阴组患者术后24h、48h时IL-6、CRP水平均显著低于经腹组( P<0.05)。结论:腹腔镜辅助下阴式子宫切除术对患者机体应激影响较小,有利于患者术后康复。%Objective:To observe the effect of laparoscopic assisted vaginal hysterectomy on the body stress patients.Method:A total of 100 patients suffered from uterine benign lesions and needed to be per-formed with elective hysterectomy admitted in our hospital were enrolled in the study and divided into the ab-dominal hysterectomy group and the laparoscopic assisted vaginal hysterectomy group, with 50 cases in each group.The changes of IL-6, CRP, WBC and serum cortisol levels before operation, 24h and 48h after oper-ation in the two groups were observed.Result: The WBC levels of 24h and 48h after operation in the two groups were significantly higher than those before operation (P<0.05).The WBC levels 24h and 48h after operation in the trans-abdominal group were significantly higher than those in the trans-vaginal group ( P<0. 05) .The comparison of serum cortisol levels in the trans-vaginal group between 24h after operation and be-fore operation was not statistically different ( P>0.05);the serum cortisol levels 48h after operation were sig-nificantly higher than those before operation and 24h after operation ( P<0.05) .The serum cortisol levels 24h and 48h after operation in the trans-abdominal group were significantly higher than those before operation ( P<0.05);and the serum cortisol levels in each timing-point after operation were significantly higher than those in the trans-vaginal group ( P<0.05) .The IL-6 and CRP levels 24h after operation in the two groups were significantly higher than those before operation ( P<0.05);the IL-6 and CRP levels 48h after operation were significantly lower than those 24h after operation ( P<0.05) , but still significantly higher than those be-fore operation ( P<0.05) .The IL-6 and CRP levels 24h and 48h after operation in the trans-vaginal group was significantly lower than those in the trans-abdominal group ( P<0.05) .Conclusion: The laparoscopic assisted vaginal hysterectomy has a little effect on the patients’ body stress and is beneficial for the postoper-ative rehabilitation.

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