【摘要】 目的：探讨高频超声刀(HS)及传统双极电凝(BE)对卵巢交界性肿瘤(BOT)患者术后应激反应及心理康复的差异性影响。方法：前瞻性纳入2023年1月至2024年6月南京医科大学第一附属医院收治的80例腹腔镜手术BOT患者，根据手术治疗方式的不同将其分为观察组和对照组，每组40例，观察组采用HS治疗，对照组采用BE治疗。检测术前及术后24 h两组患者的血清皮质醇、白细胞介素-6(IL-6)和C-反应蛋白(CRP)水平；记录手术时间、出血量、术后排气时间以及并发症发生率。通过焦虑自评量表(SAS)与抑郁自评量表(SDS)评估患者心理状态。结果：观察组术后皮质醇增幅(5.87±1.21)μg/dl，较对照组的(11.39±2.54)μg/dl降低48.47%，两组比较差异有统计学意义(t=6.971,P<0.05)；观察组术后IL-6与CRP增幅分别减少35.98%和39.89%，两组比较差异均有统计学意义(t=8.982、-9.472,P<0.05)。观察组手术时间、术中出血量及首次排气时间均显著少于对照组，两组比较差异均有统计学意义(t=5.428、10.192、8.147,P<0.05)。观察组皮下气肿与切口感染发生率均低于对照组，两组比较差异均有统计学意义(x2=5.541、3.914,P<0.05)，而深静脉血栓和肠梗阻差异无统计学意义(P>0.05)。心理评估显示，观察组术后SAS和SDS评分降幅更显著，两组比较差异均有统计学意义(t=6.742、7.118,P<0.05)。结论：HS可通过减少组织损伤降低术后应激反应，缩短康复周期并改善心理状态，可作为BOT腹腔镜手术的优选方案。更多还原

【Abstract】 Objective: To explore the differential effect of high-frequency harmonic scalpel(HS) and conventional bipolar electrocautery(BE) on postoperative stress response and psychological rehabilitation in patients with borderline ovarian tumors(BOT). Methods: A prospective cohort included 80 BOT patients underwent laparoscopic surgery at the First Affiliated Hospital with Nanjing Medical University between January 2023 and June 2024. According to different surgical methods, participants were divided into an observation group(n=40) that adopted HS treatment, and a control group(n=40) that adopted BE treatment. Serum cortisol, interleukin-6(IL-6), and C-reactive protein(CRP) concentrations were detected before and at the 24th h after surgery. The operative duration, intraoperative blood loss, time to first flatus after surgery, and complication rates were recorded. Psychological status was assessed through Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS). Results: The increased range of postoperative cortisol of the observation group was(5.87±1.21) μg/dL, which was decreased by 48.47% than(11.39±2.54) μg/dL of control group, with statistical significance(t=6.971, P<0.05). The increased range of postoperative IL-6 and CRP were respectively 35.98% and 39.89% in observation group, and there were significant differences at them between two groups(t=8.982,-9.472, P<0.05), respectively. The operative duration, intraoperative blood loss, and time to first flatus after surgery of observation group were significantly less than those of the control group(t=5.428, 10.192, 8.147, P<0.05). The incidences of subcutaneous emphysema and wound infection of observation group were lower than those of control group(x~2=5.541, 3.914, P<0.05), respectively. There were not significant differences at deep vein thrombosis and intestinal obstruction between two groups(P>0.05). Psychological assessment indicated the decreased ranges of postoperative SAS and SDS of observation group were more significant, and there were significant differences at them between two groups(t=6.742, 7.118, P<0.05), respectively. Conclusion: The comparison indicates HS can decrease postoperative stress response by reducing tissue injury, and it can shorten the rehabilitation cycle and improve psychological status, which can be used as a preferable approach for BOT laparoscopic surgery.更多还原