CAJ | 학술논문

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。
목적：관찰복강경보조하음식자궁절제술대환자궤체응격적영향。방법：선취아원수치적자궁량성질병수행택기수술치료적환자100례，기중채용복식급복강경보조하음식자궁절제술치료각50례，관찰량조환자수술전급수술후24h、48h백개소－6（IL －6）、C반응단백（ CRP ）、백세포계수（ WBC）、혈청피질순수평변화。결과：량조술후24、48h시WBC균현저고우술전（ P＜0．05）；경복조술후24h、48h시WBC현저고우경음조（ P＜0．05）；경음조환자술후24h혈청총피질순여술전비교무통계학차이（ P＞0．05），술후48h혈청총피질순교술전급술후24h현저승고（ P＜0．05）；경복조술후24、48h혈청총피질순수평균교술전현저승고（P＜0．05），차술후각시간점혈청총피질순수평균현저고우경음조（ P＜0．05）；량조술후24h시IL－6、CRP수평교술전현저승고（ P＜0．05），술후48h시IL－6、CRP 수평교술후24h현저강저（ P＜0．05），단잉현저고우술전（ P＜0．05）；경음조환자술후24h、48h시IL－6、CRP수평균현저저우경복조（ P＜0．05）。결론：복강경보조하음식자궁절제술대환자궤체응격영향교소，유리우환자술후강복。
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.