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1、腹腔镜手术对异位妊娠患者应激代谢影响��【摘要】目的评估腹腔镜和开腹手术对异位妊娠患者机体应激及代谢的影响。方法以非随机方式分为腹腔镜组、开腹手术组。分别检测术前24h、术后24h和术后72h血清中皮质醇、甲状腺激素(FT3、FT4、TSH)及肝酶(ALT、AST)水平的变化。比较两组在手术前、后外周血中上述激素及因子变化。结果①手术作为创伤均可升高血皮质醇的水平,但开腹手术组术后24h皮质醇变化较腹腔镜组更为显著,两组在术后72h均能恢复至术前水平;②腹腔镜组手术前后甲状腺相关激素(FT3、FT4、TSH)反应较为
2、轻微且恢复较为迅速,于术后72h均能恢复术前的水平。开腹组则激素水平波动较大,于术后72hFT3仍未能恢复术前水平;③腹腔镜组及开腹组对肝酶(ALT、AST)影响不明显;④两种术式的手术操作时间基本相似,但腹腔镜手术中患者的失血量明显少于开腹手术。结论腹腔镜手术较开腹手术对机体的应激及代谢的影响小,腹腔镜手术是异位症患者有效安全损伤少的治疗方法。�【关键词】腹腔镜手术;开腹手术;应激;代谢Thestudyofeffectoflaparoscopicsurgeryon8stressandmetabolismforect
3、opicpregnancypatientsDAIXiao-yun,LEAi-wen,WANGZhong-hai,etal.DepartmentofObstetricandGynecology,ShenzhenSixthPeople’sHospital,GuangdongMedicalCollege,Shenzhen518052,China�【Abstract】ObjectiveToevaluatelaparoscopicsurgeryandopensurgeryapproachs’effectonstressandm
4、etabolismofectopicpregnancypatients.MethodsWithclinicaldiagnosisandpermittingcriterion,ectopicpregnancypatientswereassignedtolaparoscopicsurgeryandopensurgery.Serumconcentrationsofcortisol、FT3、FT4、TSH、ALT、ASTweremeasuredatpreoperative24hours,postoperative24hour
5、s,postoperative72hours.Wecomparedtheirchangeintwooperativeapproachs.Results①Atpostoperative24h,thelevelofcortisolincreasedmoresignificantlyinopensurgerygroupthanthatinlaparoscopicsurgerygroup.Thecortisolrecoveredatpostoperative72hinbothgroups.Butthedegreeofchan
6、geinopen8surgerygroupwasmuchgreaterthaninlaparoscopicsurgerygroup.②thechangeofFT3、FT4andTSHwasgentlyandcouldreachthelevelofpreoperativestateatpostoperative72hinlaparoscopicsurgerygroup.ThechangeofFT3、FT4andTSHwashigh,FT3couldnotreturnatpostoperative72hinopensur
7、gerygroup.③ALTandASTdidnotchangedobviouslyinbothgroups.④Therewasnodramaticallydifferencesbetweentwogroupsonoperationtime,butbloodlossduringsurgeryinlaparoscopicgroupwaslowerthaninopensurgery.ConclusionThemetabolicandstressresponseinlaparoscopicsurgeryislightert
8、haninopensurgery.Thelaparoscopicsurgeryisakindofmoreefficient,secureandlessinjuriouswaytotheectopicpregnancypatients.�【Keywords】Laparoscopicsurgery;Opensurgery;Stress;Metabo
