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目的:比较经阴道子宫切除术(VH)与经腹子宫切除术(AH)引起患者机体应激反应程度。方法:随机选择行经阴道和经腹子宫切除术的患者各75例进行前瞻性研究,比较两种术式术后的体温高峰变化、肠蠕动恢复时间、白细胞计数、中性粒细胞比率、C-反应蛋白和白介素6的变化特点。结果:VH组术后最高平均体温明显低于AH组(P<0.01),VH组术后肠蠕动恢复时间明显早于AH组(P<0.01);AH组术后24hWBC计数比术前明显增高(P<0.01),VH组升高不明显(P>0.05);两组术后24h中性粒细胞数(neutrophil ratio,NGR)均明显升高(P<0.05),但AH组升高的更多(P<0.01)。两组术后48h的血清IL-6和CRP水平均明显高于术前(P<0.01),但AH组术后48h的CRP浓度和血清IL-6均显著高于VH组(P<0.01)。结论:VH组的应激反应程度明显轻于AH组,恢复明显早于AH组。
Objective: To compare the degree of stress response in patients with transvaginal hysterectomy (VH) and abdominal hysterectomy (AH). Methods: A total of 75 patients undergoing vaginal and abdominal hysterectomy were prospectively studied. The changes of peak temperature, recovery time of peristalsis, white blood cell count, neutrophil ratio, C- Reactive protein and interleukin 6 changes in the characteristics. Results: The highest postoperative average body temperature in VH group was significantly lower than that in AH group (P <0.01), and the recovery time of VH in group VH was earlier than that in AH group (P <0.01) (P <0.01), but no significant increase in VH group (P> 0.05). Neutrophil ratio (NGR) in both groups were significantly increased at 24 hours after operation (P <0.05) More (P <0.01). The levels of serum IL-6 and CRP in both groups at 48h after operation were significantly higher than those before operation (P <0.01). However, CRP concentration and serum IL-6 at 48h after operation in AH group were significantly higher than those in VH group (P <0.01) . Conclusion: The degree of stress response in VH group was significantly lower than that in AH group, and recovery was significantly earlier than AH group.