摘要
目的:本研究旨对分析后腹腔镜肾囊肿去顶减压术后患者应激相关指标水平变化及临床意义。方法:选取2014年7月至2018年3月接受检查并确认为肾囊肿患者120例,随机分为研究组与对照组,均为60例。研究组患者实施单孔后腹腔镜肾囊肿去顶减压术,对照组患者实施传统后腹腔镜肾囊肿去顶减压术。比较两组肾囊肿患者术前、术后第1天、2天、3天的临床效果、体温、血压和血糖水平、皮质醇、促甲状腺激素(TSH)、血总三碘甲状腺原氨酸(TT3)和总四碘甲状腺原氨酸(TT4)含量、WBC与CRP水平、IL-6与IL-8水平、IgG、IgA与IgM水平、CD4+、CD8+与CD4+/CD8+比值变化情况。结果:研究组患者与对照组患者在手术时间、住院时间以及出血量上的数值相差不大,两组相比差异均无统计学意义(P>0.05)。而研究组与对照组患者术后并发症发病率分别为5.00%与13.33%,对照组与研究组相比差异有统计学意义(P<0.05);研究组与对照组患者在术后第1天、2天、3天的体温以及血糖与术前相比差异均有统计学意义(P<0.05),而两组患者SBP以及DBP与术前相比差异均无统计学意义(P>0.05);研究组患者在术后第1天时其TT3与术前相比差异有统计学意义(P<0.05),而两组患者TSH、TT3与TT4水平与术前相比差异均无统计学意义(P>0.05);对照组患者在术后第1天、2天、3天时其CRP、IL-6与IL-8水平与研究组患者相比差异有统计学意义(P<0.05);而两组患者在术后第2天、3天时IgG、IgA与IgM水平与术前相比差异均无统计学意义(P>0.05);两组患者在术后第2天、3天时CD4+、CD8+与CD4+/CD8+与术前相比差异均无统计学意义(P>0.05)。结论:后腹腔镜肾囊肿去顶减压术后患者体温、血压、血糖、WBC与CRP等水平变化更小,且具有对患者机体免疫功能影响小,恢复速度快以及创伤较小等特点。
Objective:To analyze the changes in the level of stress-related markers in patients undergoing decompression of a new retroperitoneal renal cyst and its clinical significance.Methods:120 patients with renal cysts who were examined in our hospital from July 2014 to March 2018 were randomly divided into study group and control group,each with 60 cases.The patients in the study group underwent single-hole laparoscopic resection of renal cysts and decompression.The patients in the control group underwent conventional retroperitoneoscopic renal cyst decompression.The clinical efficacy,body temperature,blood pressure,and blood glucose levels,cortisol,thyroid stimulating hormone(TSH),total triiodothyronine(TT3),and blood were compared before and after surgery on the 1st,2nd,and 3rd days in the two groups of renal cyst patients.Total tetraiodothyronine(TT4)content,WBC and CRP levels,IL-6 and IL-8 levels,IgG,IgA and IgM levels,andCD4^+,CD8^+and CD4^+/CD8^+ratios.Results:There was no significant difference in the operation time,length of stay,and blood loss between the study group and the control group.There was no significant difference between the two groups(P>0.05).The incidence of postoperative complications in study group and control group were 5.00%and 13.33%,respectively,and the difference between control group and study group was statistically significant(P<0.05);the study group and control group were postoperative There were significant differences in preoperative and postoperative blood glucose levels between 1st,2d,and 3d(P<0.05).There was no significant difference in SBP and DBP between the two groups(P>0.05).There was a significant difference in the TT3 between the study group and the preoperative patients on the first postoperative day(P<0.05),but there was no statistically significant difference in the TSH,TT3,and TT4 levels between the two groups compared with the preoperative ones(P>0.05);The levels of CRP,IL-6 and IL-8 in the control group at the 1st,2nd,and 3rd postoperative days were significantly different from those in the study group(P<0.05);There was no significant difference in the levels of IgG,IgA and IgM between the 2nd and 3rd day after operation(P>0.05).There was no significant difference in the levels of CD4+,CD8+and CD4+/CD8^+between the two groups on the 2nd and 3rd postoperative days(P>0.05).Conclusion:After retrograde decompression of a new type of retroperitoneal renal cyst,the changes in body temperature,blood pressure,blood glucose,WBC and CRP levels are smaller,and they have little impact on the patient's immune function,rapid recovery,and less trauma.
作者
郑燕深
麦惠洪
李剑峰
甘妙平
吴喜练
ZHENG Yanshen;MAI Huihong;LI Jianfeng(Huizhou Central People's Hospital,Guangdong Huizhou 516000,China)
出处
《河北医学》
CAS
2019年第2期307-313,共7页
Hebei Medicine
基金
广东省惠州市科技计划项目
(编号:2017Y015)
关键词
后腹腔镜肾囊肿去顶减压术
单孔
肾囊肿
应激反应
Retroperitoneoscopic renal cyst decompression
Single hole
Renal cyst
Stress response
