Abstract：Objective: To analyze the changes in the level of stress-related markers in patients undergoing decompression of a new retroperitoneal renal cyst and its clinical significance. Methods: 120 patients with renal cysts who were examined in our hospital from July 2014 to March 2018 were randomly divided into study group and control group, each with 60 cases. The patients in the study group underwent single-hole laparoscopic resection of renal cysts and decompression. The patients in the control group underwent conventional retroperitoneoscopic renal cyst decompression. The clinical efficacy, body temperature, blood pressure, and blood glucose levels, cortisol, thyroid stimulating hormone (TSH), total triiodothyronine (TT3), and blood were compared before and after surgery on the 1st, 2nd, and 3rd days in the two groups of renal cyst patients. Total tetraiodothyronine (TT4) content, WBC and CRP levels, IL-6 and IL-8 levels, IgG, IgA and IgM levels, andCD4+,CD8+and CD4+/CD8+ ratios. Results: There was no significant difference in the operation time, length of stay, and blood loss between the study group and the control group. There was no significant difference between the two groups (P>0.05). The incidence of postoperative complications in study group and control group were 5.00% and 13.33%, respectively, and the difference between control group and study group was statistically significant (P<0.05); the study group and control group were postoperative There were significant differences in preoperative and postoperative blood glucose levels between 1st, 2d, and 3d (P<0.05). There was no significant difference in SBP and DBP between the two groups (P>0.05). There was a significant difference in the TT3 between the study group and the preoperative patients on the first postoperative day (P<0.05), but there was no statistically significant difference in the TSH, TT3, and TT4 levels between the two groups compared with the preoperative ones (P>0.05); The levels of CRP, IL-6 and IL-8 in the control group at the 1st, 2nd, and 3rd postoperative days were significantly different from those in the study group (P<0.05); There was no significant difference in the levels of IgG, IgA and IgM between the 2nd and 3rd day after operation (P>0.05). There was no significant difference in the levels of CD4 +, CD8 + and CD4 +/CD8+between the two groups on the 2nd and 3rd postoperative days (P>0.05). Conclusion: After retrograde decompression of a new type of retroperitoneal renal cyst, the changes in body temperature, blood pressure, blood glucose, WBC and CRP levels are smaller, and they have little impact on the patient's immune function, rapid recovery, and less trauma.
郑燕深, 麦惠洪, 李剑峰, 甘妙平, 吴喜练. 后腹腔镜肾囊肿去顶减压术后患者应激相关指标水平变化及临床意义分析[J]. 河北医学, 2019, 25(2): 307-312.
ZHENG Yanshen, MAI Huihong, LI Jianfeng, et al. Changes of Stress-related Indicators in Patients with Retroperitoneal Laparoscopic Renal Cyst Decompression and their Clinical Significance. HeBei Med, 2019, 25(2): 307-312.
[1] 马鑫,张旭,董隽,等.机器人辅助经脐单孔腹腔镜肾囊肿去顶减压术3例报告[J].微创泌尿外科杂志,2014,3(1):8~11. [2] 任选义,张雪培,刘建华,等.带蒂脂肪瓣填塞在后腹腔镜肾囊肿去顶减压术中的应用价值[J].中国全科医学,2015,18(6):700~702. [3] Zhuo W, Chai J, Xu T, et al. Retroperitoneoscopic single-site renal pedicle lymphatic disconnection for the treatment of serious filarial chyluria[J]. Canadian Journal of Urology, 2013, 20(2):6726~6729. [4] Koga H, Okawada M, Doi T, et al. Comparison between closed and open techniques for creating a retroperitoneal space for retroperitoneoscopic renal surgery in children[J]. Pediatric Surgery International, 2014, 30(9):933~936. [5] 张晓峰,常德辉,周逢海,等.单孔后腹腔镜与常规后腹腔镜肾囊肿去顶减压术的临床疗效比较[J].中国医学装备,2015,6(5):84~86. [6] 李应忠,王健,佟发春,等.后腹腔镜肾囊肿去顶减压术336例报告[J].中国微创外科杂志,2013,13(5):468~469. [7] 沙瑞丽.腹腔镜肾囊肿去顶减压术的临床护理干预[J].贵州医药,2016,40(5):554~555. [8] Hemal A K, Aron M, Gupta N P, et al. The role of retroperitoneoscopy in the management of renal and adrenal pathology[J]. Bju International, 2015, 83(9):929~936. [9] 刘建震.IUPU与自制气囊(两种建腔方式)用于单孔单通道后腹腔镜肾囊肿手术对患者疗效及应激反应的影响比较[J].解放军预防医学杂志,2016,3(2):113~114. [10] 林毅锋,姚史武,何强,等.单孔腹腔镜肾囊肿去顶术对机体免疫功能的影响[J].广东医学,2016,37(16):2459~2461. [11] 王妍妮,解建国.后腹腔镜肾囊肿去顶减压术对多囊肾患者肾功能指标及主动脉根部内径的影响[J].河北医科大学学报,2017,38(8):950~953. [12] Chai Y J, Woo J W, Kwon H, et al. Comparative outcomes of lateral transperitoneal adrenalectomy versus posterior retroperitoneoscopic adrenalectomy in consecutive patients: A single surgeon's experience[J]. Asian Journal of Surgery, 2016, 39(2):74~80. [13] 姚秀,周焱,蔡晓伟,等.针式器械辅助下的改良单孔腹腔镜手术应用体会[J].临床泌尿外科杂志,2017,13(8):603~606. [14] 刘涛,张璐,张凡.腹腔镜肾囊肿去顶术对肾囊肿患者临床疗效及应激反应变化研究[J].临床军医杂志,2016,44(10):1044~1047. [15] Lowery A J, Seeliger B, Alesina P F, et al. Posterior retroperitoneoscopic adrenal surgery for clinical and subclinical Cushing's syndrome in patients with bilateral adrenal disease.[J]. Langenbecks Archives of Surgery, 2017,9(5):1~11.
2019, Vol. 25 
冀公网安备13080202000677号