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

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。
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.