摘要
目的探讨悬吊式腹腔镜行子宫肌瘤剔除术的临床疗效和对炎性因子的影响。方法选择2015年1月—2016年6月在唐山市协和医院妇产科诊断为子宫肌瘤患者86例,分为观察组(悬吊式腹腔镜组)50例,对照组(开腹组)36例。比较手术时间、术中出血量、肛门排气时间、术后疼痛评分、术后下床时间、术后体温升高持续时间等指标。检测分析二组患者术前、术后C反应蛋白(CRP)、白细胞介素6(IL-6)和肿瘤坏死因子(TNF-α)的变化。结果观察组手术时间、术中出血量、术后疼痛评分、术后下床活动时间、术后体温升高持续时间和术后不良反应发生率低于对照组,差异有统计学意义(t=3.532~10.016,P<0.05);术后观察组1d、3d血清CRP、IL-6和TNF-α水平均低于对照组,差异有统计学意义(t=3.827~5.013,P<0.05);二组内部比较,患者术后第一天CRP,IL-6和TNF-α迅速升高,明显高于术前水平;术后第三天各指标逐渐降低,但仍高于术前水平,差异有统计学意义(t=3.832~11.863,P<0.05)。结论悬吊式腹腔镜优于传统开腹手术,引起机体免疫功能和炎症反应影响小,具有更好的临床应用价值。
Objective To investigate the curative effect and the effect on inflammatory cytokines of myomectomy performed by suspended laparoscopy. Methods Totally 50 cases of patients who accepted suspended gasless laparoscopy were set as the observation group, and 36 cases of patients who were treated by open surgery were set as the control group from Jan 2015 to Jun 2016. Main outcome measures were operating time, the amount of blood loss, exsufflation and discharge, pain score, postoperative fever. Compared the changes of CRP,IL- 6 and TNF-α before and after operation. Results The operation time,intra - operative blood loss, pain score, the bed time, postoperative adverse reaction,postoperative fever in the observation group were lower than those in the control group（t = 3. 532- 10. 016, P〈0.05）. The first day and the third day after surgery, the level of CRP, IL - 6 and TNF-α in the observation group were lower than those in the control group（t= 3. 827-5. 013,P〈0.05） ; and the level of CRP,IL - 6 and TNF -α in the observation group were higher than those in the before surgery. The control group also got the same results （t= 3. 832-11. 863,P〈0.05）. Conclusions It suggests that suspended laparoscopy has more advantages than conventional laparotomy with less impact on immune function of the body and the inflammatory response. It is worth popularizing application.
出处
《中国煤炭工业医学杂志》
2017年第5期517-520,共4页
Chinese Journal of Coal Industry Medicine
基金
河北省卫生厅科研基金项目(编号:20150998)
