不同子宫肌瘤剔除术对患者机体炎性应激状态的影响比较

目的：探讨不同子宫肌瘤剔除术对患者机体炎性应激状态的影响。方法选取2012年3月～2013年12月在本院就诊的子宫肌瘤患者90例，随机分为观察组（经阴道组）和对照组（开腹组），各45例，观察两组的手术情况、皮质醇和C-反应蛋白（CRP）。结果观察组的术中出血量少于对照组，手术时间、术后排气时间及住院时间均明显短于对照组（P〈0.05）。两组术前皮质醇水平比较，差异无统计学意义（P〉0.05）；术后24 h，两组皮质醇水平较术前升高，观察组升高水平低于对照组，差异有统计学意义（P〈0.05）；术后72 h，对照组皮质醇水平高于术前，观察组皮质醇水平低于对照组，差异有统计学意义（P〈0.05）。两组术前CRP水平比较，差异无统计学意义（P〉0.05）；术后24 h，两组CRP水平较术前升高，观察组升高水平低于对照组，差异有统计学意义（P〈0.05）；术后72 h，对照组CRP水平高于术前，观察组CRP水平低于对照组，差异有统计学意义（P〈0.05）。结论经阴道子宫肌瘤剔除术比开腹子宫肌瘤剔除术对机体应激小、创伤小，有利于患者术后的恢复。

Influence comparison of different hysteromyomectomy on patient's in-flammatory stress state

Objective To discuss the influence of different hysteromyomectomies on patient’s inflammatory stress state. Methods 90 patients with uterine fibroid visited physician in our hospital from March 2012 to December 2013 were selected and evenly divided into observation group （transvaginal group）and control group （laparotomy group）in random, each group of 45 cases.The operation situation,cortisol and C-reactive protein in two groups was observed respectively. Results The intraoperative amount of bleeding in observation group was less than that in control group,operation time, time of gas exhaust and hospital stay time in observation group was shorter than that in control group respectively （P〈0.05）.The level of cortisol before surgery in both groups was compared,with no statistical difference （P〉0.05）.After surgery of 24 hours,level of cortisol in both groups was higher than that before surgery respectively,level of cortisol in observation group was lower than that in control group,with statistical difference（P〈0.05）.After surgery of 72 hours,level of cortisol in control group was higher than that before surgery,level of cortisol in observation group was lower than that in control group,with statistical difference （P〈0.05）.The level of C-reactive protein before surgery in both groups was compared,with no statistical difference （P〉0.05）.After surgery of 24 hours,level of C-reactive protein in both groups was higher than that before surgery respectively,level of C-reactive protein in observation group was lower than that in control group,with statistical difference （P〈0.05）.After surgery of 72 hours,level of C-reactive protein in control group was higher than that before surgery,level of C-reactive protein in observation group was lower than that in control group, with statistical difference （P〈0.05）. Conclusion Compared with hysteromyomectomy by laparotomy,transvaginal hysteromyomectomy has less stress state on body and smaller trauma,which is beneficial to patient’