中华腔镜外科杂志(电子版)
中華腔鏡外科雜誌(電子版)
중화강경외과잡지(전자판)
CHINESE JOURNAL OF LAPAROSCOPIC SURGERY ( ELECTRONIC EDITION)
2015年
2期
30-33
,共4页
复杂输尿管上段结石%后腹腔镜%切开取石%炎性反应%应激反应
複雜輸尿管上段結石%後腹腔鏡%切開取石%炎性反應%應激反應
복잡수뇨관상단결석%후복강경%절개취석%염성반응%응격반응
Complicated upper ureteral calculi%Retroperitoneal laparoscopy%Lithotomy%Lnflammatory response%Stress response
目的:研究后腹腔镜输尿管切开取石术治疗复杂输尿管上段结石的有效性与安全性。方法将2013年5月至2014年6月贵州省人民医院收治的复杂输尿管上段结石130例患者纳入研究对象,采用随机数字表法分为观察组和对照组,各65例;观察组接受后腹腔镜输尿管切开取石术,对照组接受开放手术,比较两组的手术情况、炎性反应及应激反应。结果(1)手术情况:观察组手术时间明显高于对照组[(102.01±18.45)min vs (78.54±8.36)min(P <0.05)],术中出血量、术后引流量、肛门排气时间、卧床时间均明显低于对照组[(26.92±4.52)ml vs (44.46±6.41)ml、(12.41±1.75)ml vs (22.37±3.04)ml,(1.03±0.13)d vs (1.72±0.20)d、(2.74±0.42)d vs (4.29±0.63)d (P <0.05)];(2)炎性反应:观察组患者血清中白细胞介素-1、白细胞介素-6的含量低于对照组[(547.32±65.24)pg/ml vs(616.45±72.12)pg/ml、(242.25±38.36)pg/ml vs (312.45±47.56)pg/ml(P <0.05)];(3)应激反应:观察组患者血清中皮质醇、去甲肾上腺素、肾上腺素的含量低于对照组[(154.42±19.42)ng/ml vs (203.29±38.73)ng/ml、(119.31±13.24)ng/ml vs (155.57±18.57)ng/ml、(132.92±17.42)ng/ml vs (165.34±22.33)ng/ml(P <0.05)]。结论后腹腔镜输尿管切开取石术有助于减小手术创伤,缓解炎性反应、应激反应,促进术后恢复。
目的:研究後腹腔鏡輸尿管切開取石術治療複雜輸尿管上段結石的有效性與安全性。方法將2013年5月至2014年6月貴州省人民醫院收治的複雜輸尿管上段結石130例患者納入研究對象,採用隨機數字錶法分為觀察組和對照組,各65例;觀察組接受後腹腔鏡輸尿管切開取石術,對照組接受開放手術,比較兩組的手術情況、炎性反應及應激反應。結果(1)手術情況:觀察組手術時間明顯高于對照組[(102.01±18.45)min vs (78.54±8.36)min(P <0.05)],術中齣血量、術後引流量、肛門排氣時間、臥床時間均明顯低于對照組[(26.92±4.52)ml vs (44.46±6.41)ml、(12.41±1.75)ml vs (22.37±3.04)ml,(1.03±0.13)d vs (1.72±0.20)d、(2.74±0.42)d vs (4.29±0.63)d (P <0.05)];(2)炎性反應:觀察組患者血清中白細胞介素-1、白細胞介素-6的含量低于對照組[(547.32±65.24)pg/ml vs(616.45±72.12)pg/ml、(242.25±38.36)pg/ml vs (312.45±47.56)pg/ml(P <0.05)];(3)應激反應:觀察組患者血清中皮質醇、去甲腎上腺素、腎上腺素的含量低于對照組[(154.42±19.42)ng/ml vs (203.29±38.73)ng/ml、(119.31±13.24)ng/ml vs (155.57±18.57)ng/ml、(132.92±17.42)ng/ml vs (165.34±22.33)ng/ml(P <0.05)]。結論後腹腔鏡輸尿管切開取石術有助于減小手術創傷,緩解炎性反應、應激反應,促進術後恢複。
목적:연구후복강경수뇨관절개취석술치료복잡수뇨관상단결석적유효성여안전성。방법장2013년5월지2014년6월귀주성인민의원수치적복잡수뇨관상단결석130례환자납입연구대상,채용수궤수자표법분위관찰조화대조조,각65례;관찰조접수후복강경수뇨관절개취석술,대조조접수개방수술,비교량조적수술정황、염성반응급응격반응。결과(1)수술정황:관찰조수술시간명현고우대조조[(102.01±18.45)min vs (78.54±8.36)min(P <0.05)],술중출혈량、술후인류량、항문배기시간、와상시간균명현저우대조조[(26.92±4.52)ml vs (44.46±6.41)ml、(12.41±1.75)ml vs (22.37±3.04)ml,(1.03±0.13)d vs (1.72±0.20)d、(2.74±0.42)d vs (4.29±0.63)d (P <0.05)];(2)염성반응:관찰조환자혈청중백세포개소-1、백세포개소-6적함량저우대조조[(547.32±65.24)pg/ml vs(616.45±72.12)pg/ml、(242.25±38.36)pg/ml vs (312.45±47.56)pg/ml(P <0.05)];(3)응격반응:관찰조환자혈청중피질순、거갑신상선소、신상선소적함량저우대조조[(154.42±19.42)ng/ml vs (203.29±38.73)ng/ml、(119.31±13.24)ng/ml vs (155.57±18.57)ng/ml、(132.92±17.42)ng/ml vs (165.34±22.33)ng/ml(P <0.05)]。결론후복강경수뇨관절개취석술유조우감소수술창상,완해염성반응、응격반응,촉진술후회복。
Objective To study the effet and safety study on retroperitoneal laparoscopic ureterolithotomy in treating complicated upper ureteral calculi. Methods 130 cases patients with complicated upper ureteral calculi in our hospital from May 2013 to Jun.2014 were enrolled and randomly divided into observation group and control group.Observation group patients underwent retroperitoneal laparoscopic ureterolithotomy,control group patients underwent open operation.Then operation conditions, inflammation and stress response indicators were compared.Results (1)operation conditions:observation group operation time was significantly higher than that control group [(102.01 ±18.45)min vs (78.54 ± 8.36)min(P <0.05)].intraoperative bleeding volume,postoperative drainage volume,postoperative anal exhaust time,bed time were significantly lower than that control group[(26.92 ±4.52)ml vs (44.46 ± 6.41)ml,(12.41 ±1.75)ml vs (22.37 ±3.04)ml,(1.03 ±0.13)d vs (1.72 ±0.20)d,(2.74 ±0.42)d vs (4.29 ±0.63)d (P <0.05)].(2)inflammatory response:observation group serum IL-1,IL-6 contents were lower than those of control group[(547.32 ±65.24)pg/ml vs (616.45 ±72.12)pg/ml,(242.25 ± 38.36)pg/ml vs (312.45 ±47.56)pg/ml(P <0.05)].(3)stress response:observation group serum Cor, NE,E contents were lower than those of control grou[(154.42 ±19.42)ng/ml vs (203.29 ±38.73)ng/ml, (119.31 ±13.24)ng/ml vs (155.57 ±18.57)ng/ml,(132.92 ±17.42)ng/ml vs (165.34 ±22.33)ng/ml(P <0.05)].Conclusion Retroperitoneal laparoscopic ureterolithotomy is helpful to reduce operation wound,reduce inflammation and stress response,promote postoperative recovery.