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Objective To investigate deep neuromuscular blockade(NMD)and moderate NMD on hepatic perfusion and liver function during laparoscopic hepatectomy.Methods A total of 60 patients who received laparoscopic hepatectomy in Fudan University Shanghai Cancer Center were recruited from Dec 2021 to Dec 2022.They were randomly divided into two groups:deep NMD group(D group,n=30)and moderate NMD group(M group,n=30).D group was induced by administration of rocuronium 0.9 mg/kg followed by continuous infusion to maintain intraoperative post-tetanic count(PTC)of 1-2,while M group was induced by administration of rocuronium 0.6 mg/kg followed by continuous infusion to maintain intraoperative train-of-four(TOF)of 1-2.Indocyanine green(ICG)of 0.25 mg/kg was given intravenously both after induction and after specimen excision,and retention rate at fifteen minutes(ICGR15)was recorded.In addition,intraoperative rocuronium dosage,surgical operation satisfaction score,postoperative shoulder pain,and the occurrence of vomiting on postoperative day 1(POD1)were also recorded.Results Compared with M group,the dosage of rocuronium in D group was significantly increased(P<0.01),but there was no difference of ICGR15 between the two groups(P=0.581),even other parameters of perioperative liver function.The surgical operation satisfaction score was significantly higher(P<0.05),while the postoperative shoulder pain(P=0.037,OR=1.37,95%CI:1.01-1.86)and the occurrence of vomiting on POD1(P=0.017,OR=1.64,95%CI:1.07-2.53)were significantly lower in D group than those in M group.Conclusion Compared with moderate NMB,deep NMB can significantly improve surgery condition,reduce postoperative shoulder pain and vomiting.However,there was no significant difference between them on the hepatic perfusion and perioperative liver function.
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Objective:To evaluate the effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia in patients un-dergoing laparoscopic radical gastrectomy.Methods:Sixty patients who underwent elective laparoscopic radical gastrectomy were enrolled between May 2022 and October 2023 at Tianjin Medical University Cancer Institute&Hospital.Patients were assigned into two groups us-ing a random number table method:the control(group C)and the ultrasound-guided serratus anterior plane block(SAPB)(group S).Patient-controlled intravenous analgesia(PCIA)was administered at the end of the surgery.After surgery,visual analogue scale(VAS)of static pain scores was evaluated at 1,6,12,24,and 48 hours.PCIA pump was started at the VAS pain score≥4 after surgery,and sufentanil 0.1μg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA use,time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and the duration of hospitalization stay were recorded for the two groups.Results:VAS scores were significantly lower at postoperative 1,6,and 12 h in group S than in group C(P<0.05).Additionally,the number of effective uses of PCIA,and rescue analgesia were significantly lower in group S[(6.1±0.4)(2)]than in group C[(18.6±1.4)(17)](P<0.001).The time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and duration of hospital stay were shortened in group S than in group C(P<0.05).There were no significant differences in other parameters between these two groups.Conclusion:Ultrasound-guided SAPB can reduce postoperative pain and facilitate fast recovery in laparoscopic radical gastrectomy patients.
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Objective:To compare the perioperative outcomes between robotic pancreaticoduodenectomy(RPD)and laparoscopic pancreaticoduode-nectomy(LPD)in patients aged ≥65 years. Methods:The clinical data of 130 patients aged ≥65 years who received minimally invasive pancreaticoduodenectomy(MIPD)at Department of Gastrointestinal and Pancreatic Surgery,Zhejiang Provincial People's Hospital from January 2019 to December 2022 were retrospectively analyzed.The patients were divided into the RPD group(n=66)and the LPD group(n=64)according to the operation method,and the perioperative clinical data were compared between the 2 groups. Results:Compared with the LPD group,the average age of patients in the RPD group was higher than that of the LPD group[(71.95±4.73)years vs(70.39±3.9)years,P<0.05];the RPD group had more patients with diabetes(39.4%vs 18.8%,P<0.05)and cardiopulmonary diseases(37.9%vs 17.2%,P<0.05);the RPD group had shorter operation time[(272.91± 68.38)min vs(362.81±78.24)min,P<0.05]and less intraoperative blood loss[median(range):1 00 mL(50-200 mL)vs 1 50 mL(1 00-200 mL),P<0.05)];the RPD group had higher incidence of chylous fistula(1 2.1%vs 1.6%,P<0.05)but lower incidence of surgical morbidity(37.9%vs 46.9%),serious complications(19.7%vs 34.4%),postoperative pancreatic fistula(12.1%vs 17.2%),biliary fistula(3.0%vs 3.1%),abdominal infection(10.6%vs 14.1%),postoperative bleeding(4.5%vs 4.5%),and postoperative cardiopulmonary complications(1 2.1%vs 20.3%)with no statistically significant difference(P>0.05);the RPD group waited shorter time before restarting diet[(3.97±1.59)d vs(5.34±2.56)d,P<0.05]. Conclusion:MIPD is safe and feasible in patients aged ≥65 years.The incidence of perioperative complications is similar between the 2 groups.Compared with LPD,RPD has shorter operation time,less intraoperative blood loss,and shorter duration before restarting diet after operation,which has certain clinical advantages.
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Objective@#To investigate the effect of early bile regurgitation via gastric tube on gastrointestinal function in patients undergoing laparoscopic choledochotomy.@*Methods@#A total of 98 patients who underwent laparoscopic biliary tract surgery were selected treated in our hospital from August 2015 to August 2017, according to random number table method, all of the patients were randomly divided into two groups, the control group and the test group. The two groups of patients were given routine nursing intervention, the experimental group received early bile regurgitation via gastric tube. The incidence rate of postoperative abdominal distension and gastrointestinal function recovery were compared between two groups.@*Results@#After treatment, there were 10 cases of abdominal distention in the test group and 21 cases in the control group. The abdominal distention rate in the test group was 20.41%(10/49), which was significantly lower than that in the control group 42.86%(21/49) (χ2=5.934, P < 0.05). After treatment, the anal exhaust time and bowel sound recovery time in the test group were (33.01±8.29) h and (17.53±3.92) h, respectively, which were significantly lower than those in the control group (43.22±11.02) h and (23.94±7.02) h, respectively. The difference between the two groups was statistically significant. (t = 4.859, 5.823, P < 0.05).@*Conclusions@#Early bile regurgitation through gastric tube can effectively reduce the incidence of postoperative abdominal distension and promote the recovery of gastrointestinal function in patients with laparoscopic choledochotomy. It is worthy of being popularized in clinical practice.
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Objective To investigate the effect of early bile regurgitation via gastric tube on gastrointestinal function in patients undergoing laparoscopic choledochotomy. Methods A total of 98 patients who underwent laparoscopic biliary tract surgery were selected treated in our hospital from August 2015 to August 2017, according to random number table method, all of the patients were randomly divided into two groups, the control group and the test group. The two groups of patients were given routine nursing intervention, the experimental group received early bile regurgitation via gastric tube. The incidence rate of postoperative abdominal distension and gastrointestinal function recovery were compared between two groups. Results After treatment, there were 10 cases of abdominal distention in the test group and 21 cases in the control group. The abdominal distention rate in the test group was 20.41%(10/49), which was significantly lower than that in the control group 42.86%(21/49) (χ2=5.934, P<0.05). After treatment, the anal exhaust time and bowel sound recovery time in the test group were (33.01±8.29) h and (17.53±3.92) h, respectively, which were significantly lower than those in the control group (43.22±11.02) h and (23.94± 7.02) h, respectively. The difference between the two groups was statistically significant. (t=4.859, 5.823, P < 0.05). Conclusions Early bile regurgitation through gastric tube can effectively reduce the incidence of postoperative abdominal distension and promote the recovery of gastrointestinal function in patients with laparoscopic choledochotomy. It is worthy of being popularized in clinical practice.
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<p><b>OBJECTIVE</b>To observe the clinical efficacy of auricular point sticking on prevention and treatment of gastrointestinal complications after gynecological laparoscopic operation of general anesthesia, and to explore whether it is achieved by regulating the secretion of plasma motilin (MTL).</p><p><b>METHODS</b>Sixty patients who received selective gynecological laparoscopy under general anesthesia were randomly assigned into an observation group and a control group, 30 patients in each one. The patients in the observation group were treated with auricular point sticking at each morning and night, 30 min before anesthesia, revival after surgery and 24 h after surgery. The adhesive fabric with vaccaria seeds was pressed at shenmen (TF), wei (CO), benmen (CO), jiaogan (AH) and pizhixia (AT) for 3 to 5 min until the sensation of sourness, distension and numb appeared. The treatment was given for one week. The patients in the control group were treated only with similar adhesive fabric at auricular points at identical time points; each auricular point was pressed for 3 to 5 min. The anus exhaust time, defecating time and borborygmus were recorded; the level of plasma MTL was tested 30 min before anesthesia, 24 h after o-peration and 48 h after operation; the occurrence of nausea and vomiting from the end of operation to the end of treatment were also recorded.</p><p><b>RESULTS</b>Compared with the control group, the occurrence of nausea after operation was reduced in the observation group (<0.05), and the anus exhaust time and defecating time were shortened (both<0.05), and the recovery of borborygmus was improved (<0.05). The levels of MTL 24 h and 48 h after surgery were higher than those before operation in the two groups (all<0.05); The levels of MTL 24 h and 48 h after surgery in the observation group were significantly lower than those in the control group (both<0.05).</p><p><b>CONCLUSIONS</b>The assist of auricular point sticking could reduce the occurrence of nausea-vomiting and accelerate the recovery of gastrointestinal function in gynecological laparoscopic operation under general anesthesia, which is likely to be related with the inhibition on excess secretion of MTL.</p>
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Objective To compare the influence degree of laparoscopic operation and open operation on peripheral blood T lymphocyte subsets and Th1Th2 in patients with severe acute pancreatitis.Methods 54 patients who underwent surgical treatment in our hospital from February 2013 to December 2014 were selected as the subjects, 27 patients with severe acute pancreatitis who were treated with open operation as group A , 27 cases who were treated with laparoscopic operation at the same time were selected as group B , and then the peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of two groups before the operation and at first,third and seventh day after the operation were respectively detected, then the detection results of two groups were compared.Results The peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of group B at first, third and seventh day after the operation were all significantly better than those of group A , the difference was statistically significant ( P<0.05 ) , and the detection results of group A and group B at third day after the operation were worse than those at other time , the difference was statistically significant (P<0.05).Conclusion The influence of laparoscopic operation and open operation on T lymphocyte subsets and Th1Th2 in peripheral blood of patients with severe acute pancreatitis, the adverse effects of laparoscopic operation on the above indicators were relatively small.
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Objective To explore the effects of modified herringbone-Trendelenburg position during gynecological laparoscopic operation of the elderly. Methods A total of 60 elderly patients undergoing gynecological laparoscopic operation under general anesthesia were recruited and assigned to the observation group (30 cases) and control group (30 cases) by random digits table method with 30 cases each according to admitting time;Patients in the control group were placed in conventional Trendelenburg position, while the patients in the observation group were positioned in modified herringbone-Trendelenburg position .Intraocular pressure (IOP) were measured in the patients at anesthesia induction (T1),5 minutes after general anesthesia in supine position (T2) , and 5 minutes after pneumoperitoneum while in the operation position (T3) , every 30 minutes (times 4 to 11), while supine at the end of pneumoperitoneum (time 12) and before awakening (time 13);Patients were followed up at 24 h and 48 h after surgery, researcher investigate and record the scores of the Operation Position Comfort Questionnaire, the situation of the pain in the shoulder and postoperative complications of the lower limbs. Results There was no statistically significant difference (t=-1.098,-0.772,-0.656, P>0.05) of the IOP at T1, T2, T13. The IOP in the observation group had statistically significant difference compared with the control group at T3 to T12 (t=6.523-19.866, P<0.01). The incidence rate of the postoperative complications of the lower limbs in the observation group was 6.7%(2/30) lower than 26.7%(8/30) of the control group (χ2=4.320, P<0.05) and the VAS scores of the patients in the two groups was statistically significant (t=2.471, P<0.05). The incidence rate of the postoperative shoulder pain in the observation group was 10.0%(3/30) lower than 43.3%(13/30) of the control group (χ2=8.523, P<0.01), and the Visual Analogue Scale scores of the patients in the two groups was statistically significant (t=3.575, P<0.05).The scores of the Operation Position Comfort Questionnaire in the observation group was higher than the control group (t=-2.319, P<0.05). Conclusions Modified herringbone- Trendelenburg position can reduce the elevation of intraocular pressure in elderly patients without affecting the operation ,and effectively improve the comfort of the operation position of the patients, reduce the incidence rate of the shoulder pain and postoperative complications of the lower limbs, is conducive to the operation safety of elderly patients.
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Objective To investigate the clinical effects differences of three-port and single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone. Methods 110 patients with acute appendicitis complicated with gallbladder stones from August 2012 to August 2015 were randomly divided into control group (55 patients) with three-port laparoscopic operation and observation group (55 patients) with single-port laparoscopic operation;and the clinical indexes for operation related, operation overall satisfaction score of Brown, the VAS score of depression and anxiety before and after operation and postoperative complications of both groups were compared. Results The incision length of observation group was significantly shorter than control group (P< 0.05). The operative time of observation group was significantly longer than control group (P < 0.05). The operation overall satisfaction of Brown of observation group was significantly higher than control group (P < 0.05). The VAS score of depression and anxiety after operation of observation group was significantly better than control group and before operation (P<0.05). There was no signiifcant difference in the incidence of postoperative complications between 2 groups (P < 0.05). Conclusion Compared with three-port laparoscopic operation, single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone can efifciently decrease the incision length, improve the aesthetic degree and postoperative negative emotions and not lead to increased risk of postoperative complications.
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Objective To evaluate and compare the effectiveness of propofol-remifentanil closed-loop and open-loop anesthesia in gynecological laparoscopic operation under bispectral index (BIS) monitoring.Methods Forty female patients undergoing elective gynecological laparoscopic operation were recruited and randomly divided into closed-loop (group Ⅰ) and open-loop (group Ⅱ) groups.During anesthesia maintenance,the closed-loop group was administered with a BIS-feedback system to regulate the target effect-site concentration;whereas,the open-loop group was administered the target effect-site concentration according BIS value manually.The variation of non-invasive mean arterial pressure (MAP),heart rate (HR),SpO2,BIS,extubation time,consumption of propofol and remifentanil,Ramsay index,and subjective comfort grade were recorded at the selected time points.Results The extubation time in group Ⅰ was shorter than in group Ⅱ.The total dosage of propofol administered in group Ⅰ was less than that in group Ⅱ,but there was no significant difference in the total consumption of remifentanil.HR in group Ⅰ was steadier than in group Ⅱ.However,the MAP and Ramsay index were similar in both the groups.The subjective comfort grade in group Ⅰ was higher than in group Ⅱ.Conclusion The use of propofol-remifentanil closed-loop system by BIS-feedback anesthesia is safer,more controllable,with higher degree of satisfaction and sparing side-effects,we therefore recommend it during gynecological laparoscopic operations.
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Objective To elaborate the application of robotic-assisted surgery in urology. Methods The application of robotic-assisted surgery was described to the prostate, bladder, kidney, adrenal gland and pyeloplasty in the urology department. Results The robotic-assisted surgery was compared with the traditional open surgery and laparoscopic operation, and then had its prospect explored. Conclusion The robotic-assisted surgery provides 3D visual system and flexible operation, decreases the complications and hospital stay, improves the prognosis of the patient, and takes the place of the traditional operation mode.
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Objective To explore advantages of laparoscopic sphincter preserving surgery for ultra low rectal cancer . Methods From April 2006 to January 2015, we performed laparoscopic sphincter preserving surgery in 108 cases of ultra-low rectal cancer.After laparoscopic mesorectal resection and lymph node dissection were completed , transection of the rectum was performed with the Endo-GIA at 2 cm from the lower margin of the tumor .The right lower abdomen main operation port was expanded to remove the lesion and introduce the stapler base .The proximal colon was returned and the pneumoperitoneum was re-established .A colorectal end-to-end anastomosis was conducted through the anus by using a carliber 29 circular stapler . Results Laparoscopic operation was successfully accomplished in all the 108 cases.No conversion to open surgery was required .No operative mortality was encountered . The operation time was 68 -145 min ( mean, 104 min ) , the intraoperative blood loss was 10 -100 ml ( mean, 40 ml ) , the postoperative flatus time was 1-3.5 d (mean, 2.3 d), and the number of removed lymph nodes was 8-37 (mean, 12.5).There were 98 patients followed up for 6-62 months (mean, 24.6 months).No tumor metastasis or recurrence was found . Conclusion Laparoscopic total mesorectal excision of ultra low sphincter preserving operation is feasible .
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Objective To evaluate the efficacy between cylindrical abdominoperineal resection(CAPR)by laparoscopy and traditional abdominoperineal resection(APR). Methods A retrospectively analysis was done in the data of patients with low rectal cancer who underwent APR in our department from January 2010 to September 2015. The patients were divided into two groups,including cylindrical abdominoperineal resection by laparoscopy and traditional abdominoperineal resection. The operation time,intraoperative bleeding,the time of intestinal exhaust as well as the postoperative complications of the two groups were compared. Results There were no statistical differences in the intraoperative bleeding,operation time,the time of intestinal exhaust,postoperative intestinal obstruction and pulmonary infection between the two groups(P > 0.05). However,the differences in the rates of perineal incision infection and tumor intestinal perforation between the two groups were statistically significant (P < 0.05). Conclusion CAPR by laparoscopy is safer,more reliable than traditional APR,which can effectively reduce the rates of postoperative incision infection and tumor intestinal perforation of patients.
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Objective To investigate the comparison of rubber gloves collection bag, linear closing type plastic collection bags and plastic specimen collection bag is used for application effect of laparoscopic ovarian cyst resection. Methods From 2013 June to 2014 December underwent laparoscopic ovarian cyst resection in 90 cases, according to the first date of surgery were divided into 3 groups, from the standard sample collection bag for rubber gloves (A group) 30 cases, linear closing type plastic collection bag (B group) 30 cases, collecting bag plastic specimens (C group) 30 cases. Respectively calculate autologous peritoneal bag mouth opening into time, time to complete transection of tissue into the specimen collection bag time, specimen collection bag left abdominal contents to the in vitro observation time, specimen collection bags in use in the course of rupture occurrence rate of specimen content leakage. Results The 3 groups of patients with autologous abdominal time were (7.18 ± 0.61),(6.72 ± 0.57), (5.98 ± 0.30) s, the difference was not statistically significant (t=41.80, P>0.01). The 3 groups of specimens collected pouch specimens respectively (40.84± 6.27), (49.86 ± 6.10), (32.98 ± 3.93) s, group C open pocket to maintain state of distraction to amputated tissue fully into the specimen collection bag in the shortest time, with a group and B group, the difference was statistically significant (F=69.87, P<0.01). The 3 groups of specimens collected from the abdominal cavity were (498.39±55.60), (315.70±47.32), (448.65±54.90) s, the difference was statistically significant (F=96.18, P < 0.01). The 3 groups of specimens collected specimen bag collection bag rupture were 26.7% (8/ 30),10.0% (3/ 30),3.33% (1/ 30), group A of the most common (χ2=0.926, P < 0.05), The 3 groups of specimens collected the bag contents leakage were 23.30%(7/30), 6.67%(2/30)、3.33%(1/30), group A of frequency was the highest, and in group B and C, the difference had statistical significance (χ2=0.635, P<0.05). Conclusions Plastic type specimen collection bag for soft bag with built-in wire, the bag opening is a certain tension, easy operation by operation control, convenient and reliable safety, shorten operation time, reduce the occurrence of complications, reduce surgical risks and costs, and improve the office efficiency and quality of the operation.
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Objective To evaluate the clinical significance of direct trocar insertion using optical trocar in the establishment of the primary port during trans-peritoneal laparoscopic surgical procedures.Methods A prospective study was conducted by collecting the data of 120 patients who should be performed abdominal laparoscopic surgery from April 2015 to December 2015.The 120 patients were randomly divided into a research group and a control group.The research group consisted of 34 male patients and 26 female patients,mean age was (52.0 ± 11.9) years and mean BMI was (24.9 ± 2.9) kg/m2.In research group,patients were positioned laterally with the flank padded and elevated.A predetermined position was drawn prior to surgery between the umbilicus and lateral rectus abdominis,for the creation of the primary laparoscopic trocar port.The predetermined point was incised,and then the method of direct trocar insertion using the optical access trocar was used for establishment of the primary port.After this maneuver was completed the surgery continued as indicated.The control group consisted of 36 male patients and 24 female patients,whose mean age was (52.9 ± 11.4) years and mean BMI was (25.2 ± 2.4) kg/m2.This group underwent the traditional method of port construction by incision into the abdomen.The time of constructing the passage,leakage rate,bleeding rate,and injury rate of abdominal organs were compared.Results In research group,the time of building primary port was clearly shorter than that in control group (2.7min vs.15.9min,P < 0.05),the leakage rate was also obviously reduced compared to that in control group (0 vs.30%,P < 0.05).Neither groups observed any significant bleeding nor visceral organ damage throughout the study.Conclusion Direct trocar insertion using optical trocar to establish observation port is a highly efficient and safe method in trans-peritoneal laparoscopic operation,which should be research thoroughly in clinical practice.
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<p><b>OBJECTIVE</b>To observe the effect of electroacupuncture (EA) combined with general anesthesia for the immune function of patients treated with laparoscopic radical rectectomy for rectal cancer.</p><p><b>METHODS</b>Fifty patients who would receive selective laparoscopic radical rectectomy for rectal cancer with general anesthesia were randomly divided into an observation group and a control group,25 cases in each one. Fifteen minutes before anesthesia induction,patients in the observation group were treated with EA at Zusanli (ST 36) and Sanyinjiao (SP 6) until the end of operation. Sham acupuncture without piercing the skin was applied at the same acupoints in the control group, and electrodes were connected without stimulation. Interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-6 (IL-6) were quantitatively tested before anesthesia (T), at the time of abdomen closing (T) and one hour after anesthesia anabiosis (T). And serum procalcitonin (PCT) level, leucocyte count and the number of cases with increasing leucocyte (the standard number>10×10/L) were measured on the first day after operation.</p><p><b>RESULTS</b>The levels of IL-4 and IL-6 were increased apparently and the ratio of IFN-γ/IL-4 was decreased at Tcompared with those before treatment in the control group (all<0.05), but obvious change did not appear in the observation group (all>0.05). The ratio of IFN-γ/IL-4 was enhanced (<0.05),and the levels of IL-4 and IL-6 were reduced (both<0.05) at Tin the observation group compared with those in the control group. The level of PCT of the observation group was markedly lower than that of the control group on the first day after operation (<0.05). There was no statistical significance about leucocyte count and the number of cases with increasing leucocyte between the two groups (both>0.05).</p><p><b>CONCLUSIONS</b>EA at Zusanli (ST 36) and Sanyinjiao (SP 6) could alleviate the depressing immune function and inflammatory reaction of patients after laparoscopic radical rectectomy for rectal cancer.</p>
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Objective To analyse effect of different doses of parecoxib on perioperative cellular factors and the maintenance dose of propofol in patients with laparoscopic cervical cancer surgery.Methods Collected 60 patients who were diagnosed with cervical cancer in our hospital from June 2014 to June 2015.All patients underwent laparoscopic surgery,according to the injection of parecoxib different amount before induction of anesthesia divided into control group,low dose group and high dose group,20 cases in each group,respectively before anesthesia, postoperative, postoperative 12 h and postoperative 24 h, of all patients with serum IL-6, IL-12 and TNF-a level,intraoperative propofol maintenance dose,and postoperative analgesia were detected.ResuIts The levels of serum IL-6 and TNF-αin three groups showed that:high dose group low dose group>control group (P<0.05).The maintenance dose of propofol in the three groups showed that:high dose group
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Objective To compare the characteristics of remifentanil and sufentanil for tracheal intubation general anesthesia in gyneco-logical laparoscopic operation. Methods 80 patients received gynecological laparoscopic operation were randomly divided into the remifen-tanil group and the sufentanil group with 40 patients in each group, and they were performed total intravenous anesthesia with remifentanil or sufentanil respectively. Compare the changes of heart rate, mean arterial pressure in the two groups before and after induction, at the time of intubation, pneumoperitoneum, and after the operation. And differences in two groups were recorded in the recovery time, extubation time, postoperative pain in 24 hours, exhaust time and postoperative complications. Results Change trend and magnitude in heart rate, mean ar-terial pressure had no significant difference in the two groups (P>0. 05). The recovery time, extubation time in remifentanil group was shor-ter (P0. 05). Conclusion Remifentanil and sufentanil used in gynecological laparoscopic op-eration can achieve good effect. and effects of the two drugs on hemodynamics were similar. Remifentanil can recieve better effect in terms of recovery time, while sufentanil has better postoperative analgesia effect.
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Objective To compare the postoperative analgesic effect of the single dose of oxycodone and dezocine in patients who underwent gynecological laparoscopic operation. Methods Sixty patients who underwent elective gynecological laparoscopic operation were randomly divided into two groups (n=30): oxycodone group (group O) and dezocine group (group D). Fifteen minutes before the end of surgery, oxycodone 0.1 mg/kg was given in O group, and dezocine 5 mg was given to D group. Twenty minutes before the end of surgery, tropisetron 5 mg was given to both groups. Analgesia was maintained by propofol-remifentanil with TCI. The mean arterial pressure (MAP) and heart rate (HR) of T1, T2, T3 and T4 were recorded respectively in both two groups. After the operation, pain of visual analogue scale (VAS) was assessed in 2 h ,4 h , 6 h and 24 h, respectively. Results There were no significant differences in MAP and HR between two groups at T1, T2, T3 and T4 (P>0.05). The VAS score was significantly lower in group O than that of group D (P<0.05). There was significant difference in the incidence of nausea between the two groups (P<0.05). Conclusion Single dose of oxycodone 0.1 mg/kg can be used for postoperative analgesia after gynecological laparoscopic operation, and which has better analgesia than that of dezocine, except for the adverse reaction of nausea.
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Objective To observe and investigate the influence degree of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation.Methods 76 patients with gastric and duodenal ulcer perforation were selected as study subjects,and they were divided into control group(conventional open operation group)and observation group(laparoscopic operation group)according to the random number table,38 cases in each group.The serum body stress hormones and antiinflammatory,proinflammatory related indexes of the two groups at first day before operation and at first,third,seventh day after operation were respectively detected and compared.Results The serum IL -2 levels of the observation group at first,third and seventh day after operation were (3.53 ±0.24)μg/mL,(3.25 ±0.22)μg/mL and (4.37 ±0.33)μg/mL,which were higher than those of the control group(F =5.876,P <0.05),while other serum body stress hormones and antiin-flammatory,proinflammatory related indexes were all obviously lower than those of the control group (all P <0.05), there were significant differences between those postoperative evaluation results of the two groups.Conclusion The influence of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation is relatively small,and it shows that the bad body stress degree caused by the operation is relatively smaller.