机器人腹腔镜胆囊切除术后应激反应的变化

目的通过对机器人腹腔镜胆囊切除术（robot-assisted laparoscopic cholecystectomy，RLC）与常规腹腔镜胆囊切除术（conventional laparoscopic cholecystectomy，CLC）的比较，探讨RLC术后患者应激反应变化的特点。方法选择我院肝胆外科2004年4月-2005年3月收治的胆囊结石、胆囊息肉样病变52例，行RLC23例，CLC29例。比较2组手术前后患者皮质醇、c反应蛋白（CRP）、白介素-1（IL-1）、白介素-6（IL-6）及肿瘤坏死因子（TNF）等应激反应指标的变化。结果2组手术均顺利完成。2组术前、术后的皮质醇、CRP、IL-1、IL-6及TNF值均无显著性差异（P〉0．05）。RCL组内及CLC组内手术后CRP、IL-1、IL-6及TNF值均较手术前显著性升高（P〈0．05）。结论RLC术后的应激反应与CLC相似，具有微创手术的优点。

A study on stress reactions after robot-assisted laparoscopic cholecystectomy

Objective To compare robot-assisted laparoscopic cholecystectomy (RLC) versus conventional laparoscopic cholecystectomy (CLC) on changes of stress reactions in postoperative patients. Methods A total of 52 cases of gallstones or gallbladder polyps from April 2004 to March 2005 in this department was given either robot-assisted laparocopic cholecystectomy (RLC Group, 23 cases) or conventional laparoscopic cholecystectomy (CLC Group, 29 cases). Serum levels of cortisol, C-reaction protein (CRP), interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor (TNF) before and after operation of the two groups were compared. Results The operation was successfully accomplished in both groups. No significant differences were noted between the two groups in pre- and post-operative levels of cortisol, CRP, IL-1, IL-6, and TNF (P>0.05). In both RLC and CLC Group, postoperative levels of CRP, IL-1, IL-6, and TNF were significantly elevated as compared with preoperative levels (P<0.05). Conclusions Robot-assisted laparoscopic cholecystectomy presents similar changes of stress reactions as conventional laparoscopic cholecystectomy.