%0 Journal Article %T 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 %A 王军锋 %A 李娜 %A 罗卿 %J 中国内镜杂志 %D 2017 %R 10.3969/j.issn.1007-1989.2017.11.015 %X 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(sIL-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、sIL-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sIL-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(P <0.05)。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。</br>Abstract: Objective To study the impact of laparoscopic surgical intervention for severe acute pancreatitis on TNF alpha, IL - 6 and sIL-2R. Methods Take 92 patients with SAP accepted laparoscopic surgical intervention as the research object, they were divided into laparotomy group (46 cases): received traditional open surgery; laparoscopic group (46 cases): received laparoscopic surgery intervention. Then compare the levels of TNF alpha, IL-6 and sIL-2R between the two groups. Results The time of laparoscopy group was (82.21 ± 14.56) min, intraoperative blood loss was (172.23 ± 23.31) mL, total cost was (21 512.46 ± 121.35) yuan, which was less than laparotomy group; the cure rate of laparoscopic group was 93.48% (43/46). It was obviously higher than that in laparotomy group 86.96% (40/46); The complication rate was 23.91% (11/46), the death rate 6.52% (3/46) oflaparoscopic group were significantly lower than that in laparotomy group. After laparoscopic surgery, the level of TNF alpha (24.70 ± 6.90) ng/L, IL-6 (18.32 ± 8.91) ng/L and sIL-2R (98.60 ± 8.91) pmol/L was significantly lower than laparotomy group. All the differences compared between the two groups was statistical significant (P < 0.05). Conclusion The laparoscopic intervention for SAP has distinct curative effect. It can effectively reduce the rate of complications and mortality, and improve the cure rate, is deserving popularization and application. %K severe acute pancreatitis laparoscopic intervention TNF-α IL-6 sIL-2R %U http://www.zgnjzz.com/CN/abstract/abstract9334.shtml