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目的比较腹腔镜与经腹子宫肌瘤剔除术对患者手术应激反应的影响。方法选择2013年1月—2015年1月于四川省司法警官总医院妇科行子宫肌瘤剔除术的患者106例,按随机数字表分为经腹子宫肌瘤剔除术组(A组)53例与腹腔镜子宫肌瘤剔除术组(B组)53例。术后3d检测去甲肾上腺素(NE)、肾上腺素(E)、多巴胺(DA)、皮质醇(COS)水平及炎性因子(肿瘤坏死因子α、白介素-1)水平。结果两组患者治疗前NE、E、DA、COS水平比较,差异无统计学意义(P>0.05);治疗后B组NE、E、DA、COS水平低于A组,差异有统计学意义(P<0.05)。治疗前两组患者肿瘤坏死因子α、白介素-1水平比较,差异无统计学意义(P>0.05);治疗后B组肿瘤坏死因子α、白介素-1水平低于A组,差异有统计学意义(P<0.05)。结论腹腔镜子宫肌瘤剔除术较经腹子宫肌瘤剔除术手术创伤小,减少了手术导致的血管应激反应和术后炎性反应,是一种安全可行的治疗方式,但仍存在局限性,无法完全替代经腹子宫肌瘤剔除术,应综合考虑后实施。
Objective To compare the effects of laparoscopic and abdominal myomectomy on surgical stress response. Methods From January 2013 to January 2015, 106 cases of myomectomy in Gynecologic Obstetrics and Gynecology Hospital of Sichuan General Administration of Justice were divided into three groups according to random number table: 53 cases of abdominal myomectomy group (A group) And laparoscopic myomectomy (group B) 53 cases. The level of norepinephrine (NE), epinephrine (E), dopamine (DA) and cortisol (COS) and the levels of inflammatory cytokines (tumor necrosis factor alpha and interleukin-1) Results The levels of NE, E, DA and COS were not significantly different between the two groups before treatment (P> 0.05). After treatment, the levels of NE, E, DA and COS in group B were lower than those in group A P <0.05). The levels of tumor necrosis factor-α and interleukin-1 in the two groups before treatment were not significantly different (P> 0.05). After treatment, the levels of TNF-α and IL-1 in group B were lower than those in group A, the difference was statistically significant (P <0.05). Conclusions Laparoscopic myomectomy is a safe and feasible method of treatment, which is less invasive than transabdominal myomectomy and reduces the vascular stress response and postoperative inflammatory response. However, there are still some limitations , Can not completely replace the abdominal myomectomy, should be considered after the implementation.