论文部分内容阅读
目的探讨腹腔镜根治性膀胱切除术与开放手术对机体损伤程度的差异。方法收集开放根治性膀胱切除术24例(开放组),手助腹腔镜和纯腹腔镜根治性膀胱切除术14例(腹腔镜组),测定并比较两组患者在手术麻醉后、术中以及术后第三天IL-6和IFN-γ的变化以及机体全身炎症反应综合征的发生情况。结果两组患者在年龄、性别、体重指数、尿流改道方式及肿瘤分期方面均无差别(P>0.05)。腹腔镜组术后8例出现全身炎症反应综合征,占57.1%,而开放组中19例出现全身炎症反应综合征,占79.2%,两组相比无统计学意义(P=0.149)。腹腔镜组全身炎症反应综合征的平均持续时间为1.4d,而开放组为2.8d,腹腔镜组明显少于开放组(P=0.032)。腹腔镜组和开放组术中IL-6的浓度均较术前升高,但无统计学意义(P>0.05),两组术后第三天的IL-6浓度均较术前、术中明显升高(P<0.05)。两组术前IL-6的浓度无明显差异(P=0.607),但开放组术中和术后IL-6的浓度均比腹腔镜组升高更明显(P<0.05)。两组术中和术后的IFN-γ浓度均较术前降低,但两组术前、术中和术后IFN-γ浓度相比都无明显差别(P>0.05)。结论腹腔镜根治性膀胱切除手术对机体的损伤较开放手术小,全身炎症反应综合征持续的时间明显短于开放手术。
Objective To investigate the difference between the laparoscopic radical cystectomy and open surgery on the degree of injury. Methods Twenty-four cases of open radical cystectomy (open group), 14 cases of laparoscopic and laparoscopic radical cystectomy (laparoscopic group) were collected. After operation, On the third day after surgery, the changes of IL-6 and IFN-γ and the incidence of systemic inflammatory response syndrome. Results There was no difference in age, sex, body mass index, urinary diversion and tumor staging between the two groups (P> 0.05). In the laparoscopic group, systemic inflammatory response syndrome occurred in 8 cases, accounting for 57.1%. In the open group, systemic inflammatory response syndrome occurred in 19 cases, accounting for 79.2%. There was no significant difference between the two groups (P = 0.149). In the laparoscopic group, the mean duration of systemic inflammatory response syndrome was 1.4 days, compared with 2.8 days in the open group and less in the laparoscopic group than in the open group (P = 0.032). The levels of IL-6 in laparoscopic group and open group were significantly higher than those in preoperation group (P> 0.05). The IL-6 concentration in laparoscopic group and open group was higher than preoperative and intraoperative Was significantly higher (P <0.05). There was no significant difference in preoperative IL-6 concentration between the two groups (P = 0.607), but the concentration of IL-6 in the open group was significantly higher than that in the laparoscopic group (P <0.05). The intraoperative and postoperative concentrations of IFN-γ in both groups were lower than those before operation, but there was no significant difference between the two groups in preoperative, postoperative and postoperative IFN-γconcentrations (P> 0.05). Conclusions Laparoscopic radical cystectomy is more effective than open surgery on the body. The duration of systemic inflammatory response syndrome is significantly shorter than that of open surgery.