摘要
目的:分析人工标记导引法单孔单通道后腹腔镜下肾囊肿去顶减压术对围手术期指数、应激指数和CRP的影响。方法:选择2018年10月-2021年6月在佳木斯大学宏大医院泌尿外科接受腹腔镜下肾囊肿去顶减压术92例患者作为研究对象。按照随机数字表法分为观察组和对照组,每组46例。对照组行常规后腹腔镜肾囊肿去顶减压术,观察组行人工标记导引法单孔单通道后腹腔镜下肾囊肿去顶减压术。比较两组临床指标与手术前后皮质醇、促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT_(3))、总四碘甲状腺原氨酸(TT_(4))、白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平。结果:两组手术时间比较,差异无统计学意义(P>0.05);两组术中出血量、疼痛指数评分、引流量、切口长度、术后住院时间、Kiyak评分比较,差异均有统计学意义(P<0.05)。两组术后1、2、3 d皮质醇均高于术前,术后1 d的TT_(3)均低于术前,差异均有统计学意义(P<0.05);两组术后1 d皮质醇与术后1、3 d的TT_(3)水平比较,差异均有统计学意义(P<0.05);两组手术前后TSH、TT_(4)水平比较,差异均无统计学意义(P>0.05)。两组术后1、2、3 d的WBC、CRP、IL-6、IL-8水平均高于术前,且观察组患者术后1、3 d的CRP、术后1、2、3 d的IL-6及术后2、3 d的IL-8水平均低于对照组,差异均有统计学意义(P<0.05)。两组术后1、2 d的IgG和IgM及术后1 d的IgA均低于术前,且观察组术后2、3 d的IgG和术后2 d的IgM水平均低于对照组,差异均有统计学意义(P<0.05)。结论:与传统的后腹腔镜肾囊肿去顶减压术相比,人工标记导引法单孔单通道后腹腔镜下肾囊肿去顶减压术损伤小、恢复快、对患者身体影响小。
Objective:To analyze the effect of single-port and single-channel retroperitoneal laparoscopic decompression of renal cysts with manual labeling and guidance on perioperative indexes,stress indexes and CRP.Method:From October 2018 to June 2021,92 patients who underwent laparoscopic decompression of renal cysts in the Department of Urology,Hongda Hospital of Jiamusi University were selected as the research subjects.According to the random number table method,the patients were divided into the observation group and the control group,46 cases in each group.The control group was given traditional retroperitoneal laparoscopic decompression of renal cyst,the observation group was given single-port and single-channel retroperitoneal laparoscopic decompression of renal cysts with manual labeling and guidance.The clinical indicators and levels of cortisol,thyroid stimulating hormone(TSH),total triiodothyronine(TT_(3)),total tetraiodothyronine(TT_(4)),white blood cell count(WBC),C reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM)before and after surgery of two groups were compared.Result:There was no significant difference in operation time between two groups(P>0.05);there were significant differences in intraoperative blood loss,pain index score,drainage volume,incision length,postoperative hospital stay and Kiyak score between two groups(P<0.05).The levels of cortisol at 1,2,and 3 d after operation in the two groups were higher than those before operation,and TT_(3) at 1 d after operation was lower than that before operation,the differences were statistically significant(P<0.05);there were significant differences in the levels of cortisol at 1 d after operation and TT_(3) at 1 and 3 d after operation between two groups(P<0.05);there were no significant difference in WBC,CRP,IL-6 and IL-8 levels between two groups before and after operation(P>0.05).The levels of WBC,CRP,IL-6 and IL-8 in two groups at 1,2 and 3 d after operation were higher than those before operation,the levels CRP at 1 and 3 d after operation,IL-6 at 1,2 and 3 d after operation and IL-8 at 2 and 3 d after operation in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The levels of IgG and IgM at 2 and 3 d after operation and IgA at 1 d after operation in group were lower than those before operation,the levels of IgG at 2 and 3 d after operation and IgM at 2 d after operation in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Compared with traditional retroperitoneal laparoscopic decompression of renal cyst,single-port and single-channel retroperitoneal laparoscopic decompression of renal cyst with manual marking and guidance has less damage,faster recovery and less impact on patients.
作者
付伟
FU Wei(Hongda Hospital of Jiamusi University,Jiamusi 154000,China)
出处
《中国医学创新》
CAS
2022年第10期76-81,共6页
Medical Innovation of China
关键词
肾囊肿
肾囊肿去顶减压术
单孔单通道
应激反应
后腹腔镜
人工标记
Renal cyst
Decompression of renal cysts
Single-port and single-channel
Stress response
Retroperitoneal laparoscopic
Manual labeling
