摘要
目的探讨并比较泌尿外科腹膜后腹腔镜手术与传统开放手术对围手术期神经内分泌激素的影响。方法将32例病人按手术方式不同分为两组,RL组(n=20),在腹膜后腹腔镜下手术,O组(n=12),行传统开放手术。分别于手术前、手术开始后1 h、手术后第1天、手术后第2天抽取肘静脉血,应用放免法测定血清T3、T4、TSH、皮质醇(cortisol COR)、胰岛素(insulinINS)、胰高血糖素(glucogan GLU)的水平。结果两组手术前各项内分泌激素无显著差异(P>0.05)。与术前比较,手术开始后1 h、术后1、2 d各项激素水平均有所下降,两组间各项激素变化有同步性;两组间术后比较,后腹腔镜组手术后各项激素的改变均小于开放手术组,但除术后第一天的T3浓度RL组明显低于O组外(P=0.021),其余各时间点T3、T4、TSH、皮质醇(COR)、胰岛素(INS)、胰高血糖素(GLU)的浓度在两组间无统计学差异(P>0.05)。结论与传统开放手术比较,泌尿外科腹膜后腹腔镜手术的"微创",不仅表现在切口微小,对围手术期神经内分泌激素的影响也较小。
Aim To investigate the effects of retroperitoneal laparoscopie and conventional operation on neuroendocrine hormone of patients. Methods 32 cases were divided into two groups according to the operative way ： RL group received retroperitoneal laparoseopic operation （ n = 20） and O group underwent conventional operation （ n = 12）. Serum cortisol （ COR）, insulin （ INS）, glucogan （ GLU）,T3, T4 and TSH concentrations were measured preoperatively, at the 1 hour after operation, on the 1 st day and 2nd day postoperatively. Result There was no significant difference between the two group in levels of T3 , T4, TSH, INS, COR and GLU preoperatively （ P 〉 0. 05 ）. Compared with the preoperative period, the levels of each hormone were decreased at every time points during or after operation in both groups, and the changes of each hormone in RL group were less than those of the O group. There was no significant difference between the two group in levels of T4 ,TSH,INS,COR and GLU,but the levels of T3 in O group was significantly lower than that in RL group on the 1 st postoperative day （P 〈 0.05）. Conclusions Compared with the conventional operation, urological retroperitoneal laparoscopic operation produce less effects on neuroendocrine hormone of the patients.
出处
《安徽医药》
CAS
2008年第12期1176-1178,共3页
Anhui Medical and Pharmaceutical Journal
关键词
后腹腔镜手术
神经内分泌激素
应激
外科学
retroperitoneal laparoscopy
neuroendocrine hormone
stress surgery
