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目的探讨悬吊式腹腔镜行子宫肌瘤剔除术的临床疗效和对炎性因子的影响。方法选择2015年1月—2016年6月在唐山市协和医院妇产科诊断为子宫肌瘤患者86例,分为观察组(悬吊式腹腔镜组)50例,对照组(开腹组)36例。比较手术时间、术中出血量、肛门排气时间、术后疼痛评分、术后下床时间、术后体温升高持续时间等指标。检测分析二组患者术前、术后C反应蛋白(CRP)、白细胞介素6(IL-6)和肿瘤坏死因子(TNF-α)的变化。结果观察组手术时间、术中出血量、术后疼痛评分、术后下床活动时间、术后体温升高持续时间和术后不良反应发生率低于对照组,差异有统计学意义(t=3.532~10.016,P<0.05);术后观察组1d、3d血清CRP、IL-6和TNF-α水平均低于对照组,差异有统计学意义(t=3.827~5.013,P<0.05);二组内部比较,患者术后第一天CRP,IL-6和TNF-α迅速升高,明显高于术前水平;术后第三天各指标逐渐降低,但仍高于术前水平,差异有统计学意义(t=3.832~11.863,P<0.05)。结论悬吊式腹腔镜优于传统开腹手术,引起机体免疫功能和炎症反应影响小,具有更好的临床应用价值。
Objective To investigate the clinical efficacy and the impact of inflammatory factors on the laparoscopic myomectomy. Methods From January 2015 to June 2016, 86 patients with uterine fibroids diagnosed as gynecological obstetrics and gynecology in Union Hospital of Tangshan City were enrolled. Fifty patients were divided into observation group (suspended laparoscopic group), control group (open group) 36 cases. Comparison of operation time, intraoperative blood loss, anal exhaust time, postoperative pain score, postoperative ambulation time, duration of postoperative elevated body temperature and other indicators. The changes of preoperative and postoperative C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor (TNF-α) in the two groups were detected and analyzed. Results The operation time, intraoperative blood loss, postoperative pain score, postoperative ambulation time, postoperative duration of postoperative fever and postoperative adverse reactions in the observation group were significantly lower than those in the control group (t = (P <0.05). The levels of CRP, IL-6 and TNF-α in the observation group were lower than those in the control group on the 1st and 3rd postoperative day (t = 3.827-5.013, P <0.05) Within the two groups, the patients’ CRP, IL-6 and TNF-α rapidly increased on the first day after operation, which were significantly higher than the preoperative level; on the third day after operation, the indexes decreased gradually but remained higher than the preoperative level There was statistical significance (t = 3.832 ~ 11.863, P <0.05). Conclusions Pendant laparoscopy is superior to the conventional laparotomy, which has a small effect on immune function and inflammatory response and has better clinical value.