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首页> 外文期刊>Surgical Endoscopy >Disturbances in the circadian pattern of activity and sleep after laparoscopic versus open abdominal surgery.
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Disturbances in the circadian pattern of activity and sleep after laparoscopic versus open abdominal surgery.

机译：腹腔镜手术与开腹手术后的昼夜节律活动和睡眠障碍有关。

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BACKGROUND: Studies on the circadian variation in bodily functions and sleep are important for understanding the pathophysiological processes in the postoperative period. We aimed to investigate changes in the circadian variation in activity after minimally invasive surgery (laparoscopic cholecystectomy, LC) and major abdominal surgery (MAS) and if these changes correlated with postoperative subjective recovery measures. METHODS: We examined 76 and 44 patients undergoing LC and MAS, respectively, for 4 days before and after surgery. Subjective recovery parameters were assessed by visual analogue scale (sleep quality, general well-being and pain) and fatigue was measured by a ten-point fatigue scale. The activity levels of the patients were monitored by actigraphy (a wrist-worn device measuring patient activity). Measures of circadian activity level [interday stability (IS), intraday variability (IV) and the amplitude (AMP)] were derived after nonparametric analysis of activity data. RESULTS: IS was significantly reduced both after MAS (0.72 before surgery and 0.58 after surgery, p < 0.0001) and after LC (0.76 before surgery and 0.66 after surgery, p < 0.0001). The IS dropped significantly more following MAS surgery compared with following LC surgery (p < 0.001). The fragmentation of the rhythm IV increased and the amplitude dropped significantly after both LC and MAS surgery. Subjective recovery parameters were worse after MAS when compared with LC, and correlated significantly to the circadian activity parameters (IS, IV and AMP). CONCLUSION: Severely disturbed circadian activity parameters was found after both LC and MAS with worse changes after MAS. Measures of circadian activity pattern analyses correlated significantly with postoperative subjective recovery parameters.
机译：背景：对人体机能和睡眠的昼夜节律变化的研究对于理解术后的病理生理过程非常重要。我们旨在调查微创手术（腹腔镜胆囊切除术，LC）和大腹部手术（MAS）后活动的昼夜节律变化，以及这些变化是否与术后主观恢复措施相关。方法：我们检查了分别在手术前后4天接受LC和MAS治疗的76例和44例患者。通过视觉模拟量表（睡眠质量，总体幸福感和疼痛）评估主观恢复参数，并通过十点疲劳量表测量疲劳。通过活动记录仪（腕戴式设备测量患者活动）监测患者的活动水平。在对活动数据进行非参数分析后，得出了昼夜活动水平的度量[日间稳定性（IS），日内变异性（IV）和幅度（AMP）]。结果：MAS后（手术前0.72，手术后0.58，p <0.0001）和LC后（手术前0.76，手术后0.66，p <0.0001），IS均显着降低。与LC手术相比，MAS手术后IS下降明显更多（p <0.001）。 LC和MAS手术后，IV节律的片段增加，幅度明显下降。与LC相比，MAS后的主观恢复参数较差，并且与生理活动参数（IS，IV和AMP）显着相关。结论：LC和MAS后均发现昼夜节律活动参数受到严重干扰，MAS后昼夜节律变化较差。昼夜节律活动模式分析的措施与术后主观恢复参数显着相关。

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