腹腔镜下肾部分切除术治疗肾肿瘤对患者血清皮质醇和炎症因子的影响

Effects on serum cortisol and inflammatory factor of laparoscopic partial nephrectomy for renal tumors

目的探讨腹腔镜下肾部分切除术治疗肾肿瘤对患者血清皮质醇（cortisol，Cor）和炎症因子的影响。方法选择2014年5月至2016年11月本院收治的106例肾肿瘤患者，参照抽签法分为对照组与实验组，各53例，对照组采用开放性肾部分切除术治疗，实验组采用腹腔镜下。肾部分切除术治疗，比较两组手术指标、手术前后皮质醇（Cor）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、C反应蛋白（CRP）、5-烃色胺（5-HT）、视觉模拟评分（VAS）、肿瘤标志物和术后并发症发生情况。结果两组手术时间无差异（P〉0．05），实验组出血量、排气时间、住院时间均优于对照组（P〈0．05）。术前，比较两组Cor、TNF—OL、IL-6、CRP、5-HT、VAS无差异（P〉0．05）；术后，实验组Cor、TNF-α、IL-6、CRP、5-HT、VAS低于对照组[（357．73±44．63）μg／L、（76．21±9．51）ng／L、（32．64±4．11）ng／L、（24．87±3．21）mg／L、（178．45±22．40）U／L、（5．53±0．69）分比（453．02±56．74）μg／L、（116．80±14．05）ng／L、（68．45±8．94）ng／L、（82．45±10．32）mg／L、（211．44±26．36）U／L、（6．72±0．83）分]（P〈0．05）。两组手术前后肿瘤标志物比较无差异（P〉0．05）。实验组并发症率低于对照组（P〈0．05）。结论腹腔镜下肾部分切除术治疗’肾肿瘤能够使血清皮质醇和炎症因子上升，但上述指标低于开放性肾部分切除术治疗，且疼痛更轻。

Objective To discuss the effects on serum cortisol （cortisol, Cor） and inflammato- ry factor of laparoscopic partial nephrectomy for renal tumors. Methods From 2014 May to Novem- ber 2016, 106 patients with renal tumors in our hospital were divided into control group and experimen- tal group according to the draw method , 53 cases of each group, the patients in the control group un- derwent open partial nephrectomy, the experimental group underwent laparoscopic partial nephrectomy. Operation indicators, Cor, tumor necrosis factor -α（ TNF - α）, interleukin - 6 （ IL - 6） and c - re- active protein （ CRP）, 5 - hydrocarbon serotonin （5 - HT） and visual analogue scale （ VAS）, tumor markers before and after surgery, and postoperative complications between two groups were compared. Results Operation time was no difference between the two groups （ P 〉 0.05 ） , the bleeding, ex- haust time, length of hospital stay of experimental group were better than control group （ P 〈 0.05 ）. There was no significant difference in Cor, TNF - α, IL - 6, CRP, 5 - HT, VAS before surgery be- tween two groups （P 〉 0.05）. After surgery, the Cor, TNF - α, IL - 6, CRP, 5 - HT, VAS of ex- perimental group were lower than the control group （ P 〈 0. 05 ）. The hand tumor markers were no differences before and after surgery between the two groups （ P 〉 0. 05 ）. The complication rate of ex- perimental group was lower than the control group （P 〈 0.05）. Conclusions Laparoscopic nephre -ctomy for renal tumors can increase the serum cortisol and inflammation factor, but the above indicators are lower than open nephrectomy, and the pain is lighter.