后腹腔镜肾脏手术对机体应激的影响.

Objective: To study the influence of retroperitoneal laparoscopic operation on traumatic stress response. Methods: 69 patients with renal surgery were selected from the department of urology in our hospital in January 2011 to December 2013, and divided into retroperitoneal laparoscopic renal surgery group(39 cases) and open renal surgery group(30 cases). The content of ACTH, COR and CRP in two groups was detected and comparatively analyzed before operation and 1 h, 24 h and 72 h, 120 h after operation. Results: The level of ACTH and COR was statistically significant between two groups(Fgroup)=107.286, P=0.000; Fgroup=9.092, P=0.004); the level of ACTH and COR was statistically significant at all the time points(Ftime=221.454, P=0.000; Ftime=94.257, P=0.000), and the level of ACTH and COR of the two groups was significantly higher after 1 h of operation, and significantly decreased after 24 h, 72 h and 120 h,and the level of ACTH and COR was returned to the preoperative level after 72 h in laparoscopic group and after 120 h in open renal surgery group. The change of ACTH and COR in different time points was smaller in laparoscopic group than that of the open renal surgery group(Ftime*group=36.446, P=0.000; Ftime*group=7.271, P=0.000). The difference of CRP between the two groups was statistically significant(Fgroup=41.526, P=0.000); and CRP were statistically significant at all the time points(Ftime=405.201, P=0.000), after 1h,24 h and 72 h of operation, the level of CRP continued to increase in two groups, and the level of CRP was decreased after 120 h of operation, but the increase of COR in different time points was smaller in laparoscopic group than that of the open renal surgery group(F time*group=14.111, P=0.000). Conclusions: The effect of retroperitoneal laparoscopic renal surgery on stress response is less than that of open renal operation, and it can maintain the stability of the nervous system and endocrine system, and is more conducive to the recovery of the body. [ABSTRACT FROM AUTHOR]