目的　探讨妇科腹腔镜手术与剖腹手术对机体的应激反应。方法　选择 72例有妇科手术指征的患者 ,随机分为两组 ,分别行腹腔镜和剖腹手术各 36例 ,其中附件手术各 2 6例 ,子宫切除术各 10例。测术前、术后 2 4小时指血白细胞 (WBC)数 ,ELISA双抗体夹心法及琼脂单扩散法测术前、术后 2 4小时和 48小时静脉血清白细胞介素 - 6 (IL - 6 )和C -反应蛋白 (CRP)。并比较两组的手术时间、术中出血量、术后镇痛用药率、术后静脉输液日、住院日和术后发热率。结果　剖腹组术后 2 4小时WBC计数比术前明显增高 (P <0 0 1) ,腹腔镜组升高不明显 (P >0 0 5 ) ;两组术后 2 4小时、48小时血清IL - 6和CRP水平均明显高于术前 (P <0 0 1) ,但剖腹组术后 2 4小时、48小时的血清IL - 6和CRP浓度均显著高于腹腔镜组 (P <0 0 1)。与剖腹手术相比 ,腹腔镜手术出血少 ,用药少 ,术后体温升高率低 ,住院日短。结论　腹腔镜手术后机体应激的反应水平较剖腹手术低 ,与创伤程度小有关 Objective To investigate the stress response of gynecological laparoscopic surgery and laparotomy on the body. Methods Seventy-two patients with indications for gynecological surgery were randomly divided into two groups. Laparoscopy and laparotomy were performed in 36 cases, of which 26 cases were accessory surgery and 10 cases were hysterectomy. The numbers of white blood cells (WBCs), IL - 6 (IL - 6) in preoperative and postoperative 24 h and 48 h after operation were measured by ELISA double antibody sandwich method and agar diffusion assay. ) And C-reactive protein (CRP). The operation time, intraoperative blood loss, postoperative analgesic dosage, postoperative intravenous infusion, hospitalization and postoperative fever were compared between the two groups. Results The WBC count at 24 hours after operation was significantly higher in the laparotomy group (P <0.01) than that in the laparoscopic group (P> 0.05). The levels of IL-4 at 24 and 48 hours after operation - 6 and CRP levels were significantly higher than those before operation (P <0.01). However, serum IL - 6 and CRP concentrations at 24 h and 48 h after operation in laparotomy group were significantly higher than those in laparoscopic group (P <0 0 1). Compared with laparotomy, laparoscopic surgery less bleeding, less medication, postoperative rise in body temperature is low, short hospital stay. Conclusions The response to body stress after laparoscopic surgery is lower than that of laparotomy and is related to the small degree of trauma