胸腔镜与开胸手术对肺癌患者术后炎症反应的对比研究

发布时间：2018-06-22 19:51

本文选题：电视胸腔镜手术 + 开胸手术　；参考：《昆明医科大学》2016年硕士论文

【摘要】：[目的]：本实验通过检测原发性肺癌患者经胸腔镜及开胸手术围手术期血清中IL-6和CRP因子含量的变化,对比胸腔镜和开胸手术对肺癌患者的创伤程度,为胸腔镜的推广提供理论依据。[方法]：采用ELISA方法检测30例行胸腔镜手术的原发性肺癌患者及30例行开胸手术的原发性肺癌患者围手术期血清中al-AT、IL-4、IL-6及CRP的水平。[结果]：1.术后两组患者的血清al-AT水平均较术前明显升高,胸腔镜组术后24h、72h、120h的血清al-AT水平均低于开胸组,差异有统计学意义(P0.05)。2.腔镜组与开胸组两组的IL-4和IL-6水平在术后24h、术后72h、术后120h均较术前增高(P0.05),而腔镜组术后120h的IL-4水平对比术后24h、术后72h两个时间位点出现下降,其浓度与术前相近(P0.05)。3.术前两组患者C-反应蛋白水平比较差异无统计学意义(P0.05),术后胸腔镜组与开胸组两组患者C-反应蛋白较术前均有增高(P0.001),而术后72h腔镜组与开胸组对比中,CRP浓度组间差异有统计学意义(P0.05)。[结论]：1.与开胸手术相比,胸腔镜治疗肺癌的术后炎症反应更低;2. al-AT可作为肺癌患者术后炎症反应程度的一项具有潜力的检测指标；3.IL4、IL6可以作为评估患者术后炎症反应的指标。
[Abstract]:[objective]: to investigate the changes of IL-6 and CRP in serum of patients with primary lung cancer during thoracoscopic and open thoracotomy, and to compare the degree of trauma between thoracoscopy and thoracotomy. To provide theoretical basis for the popularization of thoracoscopy. [methods] Elisa was used to detect the levels of IL-6 and CRP in serum of 30 patients with primary lung cancer undergoing thoracoscopic surgery and 30 patients with primary lung cancer undergoing thoracotomy. [result]: 1. The level of serum al-AT in the thoracoscopic group was significantly higher than that in the preoperative group, and the serum al-AT level in the thoracoscopic group was significantly lower than that in the thoracoscopic group at 24 h or 72 h or 120 h after operation (P0.05). The levels of IL-4 and IL-6 in endoscopic group and thoracotomy group were significantly higher than those before operation at 24 hours, 72 hours and 120 hours after operation (P0.05), while the levels of IL-4 in endoscopic group at 120h after operation were lower than those in 24 hours after operation, and at 72 hours after operation, the concentration of IL-4 was similar to that before operation (P0.05). There was no significant difference in the level of C-reactive protein between the two groups before operation (P0.05). The level of C-reactive protein in the thoracoscopic group and the thoracotomy group was higher than that in the preoperative group (P0.001), but at 72 hours after operation, the CRP concentration in the endoscopic group and the open-chest group was higher than that in the open group (P0.01). The difference was statistically significant (P0.05). [conclusion]: 1. Compared with open thoracotomy, the postoperative inflammatory response of patients with lung cancer treated by thoracoscopy was lower than that of thoracoscopic surgery. Al- AT could be used as a potential indicator of the degree of postoperative inflammatory reaction in patients with lung cancer. 3. IL-4 / IL6 could be used as an index to evaluate postoperative inflammatory response of patients with lung cancer.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R734.2

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