腹腔镜肝切除的机体应激反应

Stress reaction in patients after laparoscopic hepatectomy

  • 摘要: 目的: 研究腹腔镜肝切除手术的机体应激反应的影响。方法: 选择2004年6月-2005年2月LH连续病例20例,比较患者术前、术后即刻及术后第1、2、3天血清皮质醇、C-反应蛋白(CRP)、血糖、白细胞(WBC)计数和中性粒细胞(N)比例的变化。结果: LH术后各应激指标迅速升高(P<0.01),皮质醇术后即刻即达到高峰,第2天降正常;血糖、CRP、WBC和N的峰值都出现在术后第1天,血糖术后第2天降至术前水平,CRP术后第3天仍高于术前(P<0.01);WBC和N术后第3天降至正常范围,但仍高于术前(P<0.01)。结论: 腹腔镜肝切除能引起机体明显的应激反应,围手术期要加强内稳态的调整。

     

    Abstract: Objective: To study the stress reaction in patients after laparoscopic hepatectomy(LH). Methods: Twenty consecutive patients after LH were selected in PLA General Hospital from Junuary2004 to February 2005.Cortisol,C-reative protein(CRP),blood glucose,white blood cells(WBC),and neutrocytes(N) in these patients were detected and compared before and the first three days after operation. Results: The serum cortisol,CRP,blood glucose,WBC and N increased quickly after operation,and most of them reached their peak in the next morning after operation.The level of stress markers was significantly different before and after operation(P<0.01).The concentrations of cortisol and blood glucose returned to their normal range 2 days after operation(P>0.05),but the concentrations of CRP,WBC and N were higher 3 days after operation than before operation(P<0.01). Conclusion: LH can result in stress reaction in patients and internal homeostatic adjustment should be strengthened during perioperation.

     

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