摘要
目的探讨开放手术与后腹腔镜下肾癌根治术对患者白细胞、血清皮质醇、甲状腺素及C反应蛋白(CRP)的影响,比较机体对两种不同手术方式的创伤应激反应。方法选择行后腹腔镜肾癌根治术患者24例和开放手术患者26例,分别于术前、术后1d、3d、6d抽取静脉血测定白细胞数、血清皮质醇、甲状腺素(FT3、FT4)及C反应蛋白CRP含量进行对比研究。结果术后第1天腹腔镜组和开放手术组的白细胞数、血清皮质醇、CRP含量均较术前增加(P<0.05),血清FT3、FT4含量较术前降低(P<0.05),但后腹腔镜组和开放手术组间对比没有显著性差异(P>0.05)。术后第3天,后腹腔镜组和开放手术组的各项指标均开始缓慢恢复,组间对比有显著性差异(P<0.05)。术后第6d,后腹腔镜组除白细胞数外的所有指标均恢复术前水平,而开放手术组的各项指标未能恢复术前水平(P<0.05)。结论开放手术与后腹腔镜肾脏肾癌根治术在术后第1d对机体造成的创伤应激反应没有差异,但后腹腔镜组的机体恢复速度快于开放手术组。
Objective To investigate the influence of retroperitoneoscopic radical nephrectomy （RRN） and open nephrectomy （ON） on the stress response of patients. Methods RRN group had 24 patients and the ON group had 26 patients. The white blood cell （WBC） count, serum level of corticosteroid, FT3, FT4 and C-reactive protein （CRP） were evaluated preoperatively as well as 1d, 3d, 6d postoperatively. Results On ld after operation, serum levels of FT3, FT4 decreased, and the white blood cell （WBC） count, serum level of corticosteroid and CRP increased, reaching their peaks in RRN and ON groups. There was no significant difference between RRN and ON groups. On 3d after operation, serum level of FT3, FT4, corticosteroid and CRP gradually recovered, and there were significant difference between RRN and ON groups. On 6d after operation, serum level of FT3, FT4, corticosteroid and CRP had recovered to the preoperative levels in RRN groups, not in ON groups. Conclusions There was no significant difference between retroperitoneoscopic radical nephrectomy and open nephrectomy on the stress response of patients in ld after operation. However, the recover rate in RRN groups was faster than in ON groups.
出处
《中华腔镜泌尿外科杂志（电子版）》
2009年第1期49-52,共4页
Chinese Journal of Endourology(Electronic Edition)
