Labib M, Palfrey S, Paniagua E, Callender R
Department of Clinical Biochemistry, Russells Hall Hospital, Dudley, West Midlands, UK.
Ann Clin Biochem. 1997 Sep;34 ( Pt 5):543-5. doi: 10.1177/000456329703400509.
The magnitude of the inflammatory response to surgery depends on the degree of injury during surgical procedures. Laparoscopic techniques are generally associated with less postoperative pain and shorter hospital stay compared with open procedures, presumably due to less tissue injury and reduced inflammatory response. However, no study has been done, to our knowledge, to assess the inflammatory response to surgical trauma following laparoscopic assisted vaginal hysterectomy. We have, therefore, compared the magnitude of the inflammatory response to injury after laparoscopically assisted vaginal hysterectomy (11 patients) and abdominal hysterectomy (11 patients) by measuring serum C-reactive protein (CRP) and interleukin-6 (IL-6) on admission, and at 24 and 48 hours after the operation. Postoperatively, serum CRP rose significantly in both groups but levels in patients who underwent laparoscopically assisted vaginal hysterectomy were significantly lower than in those who underwent abdominal hysterectomy. Serum IL-6 rose significantly after abdominal hysterectomy but not after laparoscopically assisted vaginal hysterectomy. Our results show that the inflammatory response to surgical trauma was significantly less after laparoscopically assisted vaginal hysterectomy than after abdominal hysterectomy confirming that the laparoscopic procedure causes less tissue damage than the abdominal procedure.
手术炎症反应的程度取决于手术过程中的损伤程度。与开腹手术相比,腹腔镜技术通常术后疼痛较轻,住院时间较短,这可能是因为组织损伤较少,炎症反应减轻。然而,据我们所知,尚未有研究评估腹腔镜辅助阴式子宫切除术后手术创伤的炎症反应。因此,我们通过在入院时以及术后24小时和48小时测量血清C反应蛋白(CRP)和白细胞介素-6(IL-6),比较了腹腔镜辅助阴式子宫切除术(11例患者)和腹式子宫切除术(11例患者)后损伤的炎症反应程度。术后,两组患者血清CRP均显著升高,但腹腔镜辅助阴式子宫切除术患者的水平显著低于腹式子宫切除术患者。腹式子宫切除术后血清IL-6显著升高,但腹腔镜辅助阴式子宫切除术后未升高。我们的结果表明,腹腔镜辅助阴式子宫切除术后手术创伤的炎症反应明显低于腹式子宫切除术,证实腹腔镜手术比开腹手术造成的组织损伤更小。