腹腔镜与腹式全子宫切除术术后疲劳综合征的对比研究

目的:对比分析腹腔镜与腹式全子宫切除术术后疲劳综合征的特点。方法:126例患者根据手术方式分为腹腔镜组(58例)与开腹组(68例),分别于术前(T0),术后第1天(T1)、第3天(T2)、第5天(T3)进行Christensen疲劳评分、利势手握力测试,并抽取空腹静脉血化验白蛋白、转铁蛋白、前白蛋白、维A结合蛋白、C反应蛋白、IL-6、TNF-α和白细胞计数,将两组结果进行对比。结果:术前两组患者各项目差异均无统计学意义(P>0.05)。术后腹腔镜组各测试时间点疲劳评分较低,利势手握力较高,前白蛋白和维A结合蛋白较高,炎症指标水平较低,但两组血浆白蛋白和转铁蛋白差异无统计学意义(P>0.05)。结论:腹腔镜全子宫切除术可减轻术后炎症水平,减少对机体营养状态的影响,有效降低了患者术后疲劳综合征的严重程度,利于术后康复。

Comparative study of postoperative fatigue syndrome between laparoscopic and abdominal total hysterectomy

Objective:To compare and analyze the characteristics of postoperative fatigue syndrome between laparoscopic and abdominal total hysterectomy.Methods:One hundred and twenty-six patients were divided into laparoscopic group(58 cases) and open group(68 cases) according to the surgical approach.Four time points,preoperative(T0),postoperative 1st(T1),3rd(T2) and 5th(T3) day,were set to compare the following items in two groups:Christensen fatigue score,dominant hand strength test and blood test including albumin,transferrin,prealbumin,retinol binding protein,C-reactive protein,IL-6,TNF-α and white blood cell count.Results:No statistical differences were recorded preoperatively between two groups.Compared with the open group,on all time points the laparoscopic group had lower fatigue scores,higher dominant hand strength,higher prealbumin and retinol binding protein,and lower inflammatory markers,but postoperative albumin and transferrin were similar between two groups.Conclusions:Laparoscopic total hysterectomy can reduce the level of postoperative inflammation and the impact on nutritional status,and relieve the severity of postoperative fatigue syndrome effectively.Laparoscopic hysterectomy favors the recovery for patients from hysterectomy.