摘要
目的:探讨单孔后腹腔镜手术对肾囊肿患者应激反应、肾功能及术后康复的影响,为其临床诊治提供参考。方法:选取2016年4月-2021年3月三明市中西医结合医院泌尿外科收治的90例肾囊肿患者,按照手术方式将其分为对照组(n=50)和观察组(n=40)。对照组给予传统腹腔镜手术治疗,观察组给予单孔后腹腔镜手术治疗。比较两组手术相关指标、术后康复情况、免疫功能(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、肾功能[血尿素氮(BUN)、血肌酐(Scr)、血清血胱抑素C(CysC)]及应激反应指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、血清皮质醇(Cor)]。结果:观察组住院时间及手术时间均短于对照组,出血量少于对照组(P<0.05)。术前,两组CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)、BUN、Scr、CysC、IL-6、CRP、Cor比较,差异均无统计学意义(P>0.05)。术后3 d,两组CD4^(+)、CD4^(+)/CD8^(+)均低于术前,CD8^(+)高于术前,且观察组CD4^(+)、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。术后3 d,两组BUN、Scr、CysC均低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。术后3 d,两组IL-6、CRP、Cor水平均高于术前,观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组首次下床时间、首次肛门排气时间均早于对照组,NRS评分低于对照组,差异均有统计学意义(P<0.05)。结论:单孔后腹腔镜手术治疗肾囊肿患者,可以有效地降低其应激反应、降低免疫抑制,改善肾功能,促进患者的术后康复,具有一定的临床应用价值。
Objective:To explore the impact of single port retroperitoneal laparoscopic surgery on the stress response,renal function and postoperative rehabilitation of patients with renal cysts,and provide references for clinical diagnosis and treatment.Method:A total of 90 patients with renal cysts admitted to Urology Department of Sanming Hospital of Integrated Traditional Chinese and Western Medicine from April 2016 to March 2021 were selected,they were divided into control group(n=50)and observation group(n=40)according to surgical methods.The control group was treated with traditional laparoscopic surgery,and the observation group was treated with single port retroperitoneal laparoscopic surgery.The surgical indicators,postoperative recovery,the immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),renal function[blood urea nitrogen(BUN),serum creatinine(Scr),serum cystatin C(CysC)]and stress response indexes[interleukin-6(IL-6),C-reactive protein(CRP),serum cortisol(Cor)]were compared between groups.Result:The hospitalization time and surgical time in the observation group were shorter than those in the control group,and the bleeding volume in the observation group was less than that in the control group(P<0.05).Before surgery,there were no significant differences in CD4^(+),CD8^(+),CD4^(+)/CD8^(+),BUN,Scr,CysC,IL-6,CRP and Cor between two groups(P>0.05).Three day after surgery,CD4^(+)and CD4^(+)/CD8^(+)in both groups were lower than those before surgery,and CD8^(+)in both groups were higher than those before surgery,CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and CD8^(+)in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).Three day after surgery,BUN,Scr,CysC in both groups were lower than those before surgery,those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Three day after surgery,the levels of IL-6,CRP and Cor in both gr
作者
谢锡滨
XIE Xibin(Sanming Hospital of Integrated Traditional Chinese and Western Medicine,Sanming 365000,China)
出处
《中外医学研究》
2022年第23期21-25,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
单孔后腹腔镜手术
肾囊肿
应激反应
肾功能
术后康复
Single port retroperitoneal laparoscopic surgery
Renal cyst
Stress response
Renal function
Postoperative recovery
