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目的 :探讨后腹腔镜肾囊肿去顶减压术对机体的应激反应。方法 :将 3 5例肾囊肿患者随机分成后腹腔镜组与开放手术组。分别于术前 2 4h和术后第 1、3天测定血白细胞总数 (WBC)、血清C -反应蛋白 (CRP)和白细胞介素 -6(IL -6)的浓度 ,并比较两组的平均手术时间、术中出血量、术后平均引流量、术后镇痛用药量、术后发热率、术后平均住院日和费用。结果 :开放手术组术后第 1天WBC计数比术前明显升高 (P <0 .0 5) ,后腹腔镜组升高不明显 (P >0 .0 5)两组术后第 1、3天血清CRP和IL -6水平显著高于术前 (P <0 .0 5) ,但开放手术组血清CRP和IL -6均显著高于后腹腔镜组 (P <0 .0 1)。与开放手术相比 ,后腹腔镜手术具有出血少 ,引流量少 ,术后发热率低 ,用药少、住院日短等优点。结论 :后腹腔镜肾囊肿去顶术对机体的应激反应较开放手术低 ,有望替代传统开放手术
Objective: To investigate the stress response of retroperitoneal laparoscopic renal cyst debridement to the body. Methods: 35 patients with renal cysts were randomly divided into post-laparoscopic group and open surgery group. The WBC, C - reactive protein (CRP) and interleukin - 6 (IL - 6) levels were measured at 24 hours and 1 and 3 days after operation respectively. The mean Operation time, intraoperative blood loss, postoperative average drainage volume, postoperative analgesic dosage, postoperative fever rate, average postoperative hospital stay and costs. Results: The WBC count in open surgery group was significantly higher than that before operation (P <0.05), but not in retroperitoneal laparoscopic group (P> 0.05) Serum levels of CRP and IL-6 in 3 days were significantly higher than those in preoperation (P <0.05). However, the serum levels of CRP and IL-6 in open surgery group were significantly higher than those in retroperitoneal laparoscopic group (P <0.01). Compared with open surgery, retroperitoneal laparoscopic surgery with less bleeding, less drainage, postoperative fever, less medication, shorter hospitalization days and so on. Conclusions: The retroperitoneal laparoscopic renal cyst debridement has a lower stress response to the body than open surgery and is expected to replace traditional open surgery