腹腔镜手术治疗重症急性胰腺炎及对TNF-α、IL-6和sIL-2R水平的影响

发布时间：2018-03-15 00:36

本文选题：重症急性胰腺炎　切入点：腹腔镜手术　出处：《中国内镜杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨重症急性胰腺炎(SAP)腹腔镜手术治疗的临床疗效及对肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和可溶性白细胞介素-2受体(s IL-2R)水平的影响。方法收集到西安交通大学第一附属医院接受外科手术治疗的SAP患者92例作为本次研究对象,将其分为开腹组46例,给予传统开腹手术治疗,腹腔镜组46例,实施腹腔镜手术治疗,对比两组相关指标差异及对TNF-α、IL-6、s IL-2R水平的影响。结果腹腔镜组手术时间(82.21±14.56)min、术中出血量(172.23±23.31)ml、手术总费用(21 512.46±121.35)元及住院天数(16.81±0.58)d均少于开腹组;腹腔镜组治愈率93.48%(43/46)明显高于开腹组76.08%(35/46);其并发症率10.86%(5/46),死亡率2.17%(1/46)均明显低于开腹组;术后腹腔镜组TNF-α(24.70±6.90)ng/L、IL-6(18.31±8.91)ng/L及s IL-2R(98.60±8.91)pmol/L明显低于开腹组,以上数据组间对比差异有统计学意义(P0.05)。结论采用腹腔镜手术治疗SAP,其疗效显著,可有效降低并发症率与死亡率,且提高治愈率,值得推广应用。
[Abstract]:Objective to investigate the clinical efficacy of laparoscopic surgery for severe acute pancreatitis (SAP) and its effects on the levels of tumor necrosis factor- 伪 (TNF- 伪), interleukin-6 (IL-6) and soluble interleukin-2 receptor (IL-2R) in patients with severe acute pancreatitis (SAP). Methods the clinical data were collected from Xi'an Jiaotong University. Ninety-two SAP patients who received surgical treatment in the first affiliated Hospital were selected as the subjects of the study. The patients were divided into open group (n = 46) and laparoscopic group (n = 46). Results the operative time was 82.21 卤14.56 min, the intraoperative bleeding volume was 172.23 卤23.31 ml, the total operation cost was 21,512.46 卤121.35) and the length of stay was 16.81 卤0.58 days. The cure rate of the laparoscopic group was significantly higher than that of the laparotomy group (76.08 / 35 / 46); the complication rate was 10.86 / 546 and the mortality was 2.17 / 46) significantly lower than that of the laparotomy group, and the postoperative TNF- 伪 level of 24.70 卤6.90 ng / L IL-618.31 卤8.91 ngL and s IL-2R(98.60 卤8.91 渭 mol / L were significantly lower in the laparoscopy group than in the laparotomy group. Conclusion Laparoscopic surgery is effective in the treatment of SAP, which can effectively reduce the rate of complications and mortality, and increase the cure rate, which is worth popularizing.
【作者单位】：核工业四一七医院检验科;西安交通大学第一附属医院检验科;核工业四一七医院外一科;
【分类号】：R657.51

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