重症胰腺炎外科手术的治疗效果及对患者TNF-α、IL-6水平的影响

Effect of Surgical Treatment of Severe Pancreatitis and its Effect on TNF-α and IL-6 Levels in Patients

目的探析胰腺炎患者接受外科手术治疗的临床疗效,并对比手术前后患者的TNF-α与IL-6变化情况。方法选择江门市五邑中医院自2017年8月至2020年8月收入的重症胰腺炎患者67例入组,开展回顾性研究,根据治疗方式不同划分两组,一组为对照组,共有病例32例,以常规开腹手术治疗;一组为观察组,共有病例35例,以腹腔镜手术治疗,记录两组患者的手术所用时间、术中出血量、术后肠道恢复时间、血淀粉酶恢复时间;评估两组患者的临床疗效,检测两组患者治疗后的肿瘤坏死因子-α(TNF-α)与白细胞介素-6(IL-6)指标的改变情况。结果观察组患者术中出血量、术后肠道恢复时间、血淀粉酶恢复时间明显短于对照组(P<0.05);观察组患者术后的TNF-α与IL-6指标均优于对照组(P<0.05),两组结果统计对比差异明显;观察组与对照组手术时间与总有效率方面比较无差(P>0.05)。结论重症胰腺炎患者接受外科手术治疗时,选用腹腔镜手术治疗的临床疗效更确切,术后恢复效果更好,且可有效降低炎性因子水平,临床疗效确切。

Objective To explore the clinical efficacy of surgical treatment for pancreatitis,and to compare the changes of TNF-αand IL-6 in patients before and after surgery.Methods 67 patients with severe pancreatitis in Wuyi Hospital of Traditional Chinese Medicine from August 2017 to August 2020 were selected for retrospective study.According to different treatment methods,they were divided into two groups.One group was the control group,with a total of 32 cases,which were treated with conventional open surgery.The observation group(n=35)was treated by laparoscopic surgery.The operative time,intraoperative blood loss,postoperative intestinal recovery time and blood amylase recovery time of the two groups were recorded.The clinical efficacy of the two groups was evaluated,and the changes of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)indexes were detected after treatment in the two groups.Results The amount of intraoperative blood loss,postoperative intestinal recovery time and blood amylase recovery time in observation group were significantly shorter than those in control group(P<0.05).The indexes of TNF-αand IL-6 in observation group were better than those in control group after operation(P<0.05),and there were significant statistical differences between the two groups.There was no difference in operation time and total effective rate between the observation group and the control group(P>0.05).Conclusion When severe pancreatitis patients receive surgical treatment,laparoscopic surgery has more definite clinical efficacy,better postoperative recovery effect,and can effectively reduce the level of inflammatory factors,with definite clinical efficacy.