不同术式对子宫切除术后患者机体应激的影响

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。方法选取六安市人民医院2013年10至2014年12月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24、48小时白介素6(IL-6)、C反应蛋白(CRP)、白细胞计数(WBC)、血清皮质醇水平变化。结果两组患者术后24、48小时WBC均高于术前(P<0．05)；经腹组术后24、48小时WBC高于经阴组(P<0．05)；经阴组患者术后24小时血清总皮质醇与术前比较差异无统计学意义(P>0．05)，术后48小时血清总皮质醇较术前及术后24小时升高(P<0．05)；经腹组术后24、48小时血清总皮质醇水平均较术前升高(P<0．05)，且术后各时间点血清总皮质醇水平均高于经阴组(P<0．05)；两组患者术后24小时IL-6、CRP水平较术前升高(P<0．05)，术后48小时IL-6、CRP水平较术后24小时降低(P<0．05)，但仍高于术前(P<0．05)；经阴组患者术后24、48小时IL-6、CRP水平均低于经腹组(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。

Effect of different operation methods on body stress of patients after hysterectomy

Objective To observe the effect of laparoscopic assisted vaginal hysterectomy on the body stress of patients. Methods A total of 100 patients suffered from uterine benign lesions and needed to be performed with elective hysterectomy admitted in our hospital from October 2013 to December 2014 were enrolled in our study and divided into the abdominal hysterectomy group and the laparoscopic as-sisted vaginal hysterectomy group with 50 cases in each group. The changes of IL-6, CRP, WBC, and serum cortisol levels before operation, 24 h and 48 h after operation in the two groups were observed. Results WBC levels 24 h and 48 h after operation in the two groups were sig-nificantly higher than those before operation (P<0. 05). WBC levels 24 h and 48 h after operation in the trans-abdominal group were signifi-cantly higher than those in the trans-vaginal group (P<0. 05). The comparison of serum cortisol levels in the trans-vaginal group between 24 h after operation and before operation was not statistically different (P>0. 05);the serum cortisol levels 48 h after operation were significant-ly higher than those before operation and 24 h after operation ( P<0. 05 ) . The serum cortisol levels 24 h and 48 h after operation in the trans-abdominal group were significantly higher than those before operation ( P<0. 05 ); the serum cortisol levels in each timing-point after operation were significantly higher than those in the trans-vaginal group ( P<0. 05 ) . IL-6 and CRP levels 24 h after operation in the two groups were significantly higher than those before operation ( P<0. 05 ); IL-6 and CRP levels 48 h after operation were significantly lower than those 24h after operation (P<0. 05), but still significantly higher than those before operation (P<0. 05). IL-6 and CRP levels 24 h and 48 h after operation in the trans-vaginal group was significantly lower than those in the trans-abdominal group (P<0. 05). ConclusionThe laparoscopic assisted vaginal hysterectomy has limited effect on the patients' body stress and is beneficial for the postoperative rehabilita-tion.