重症胰腺炎行腹腔镜引导小网膜囊置管灌洗时IL_2和IL_6变化

Study the chang of serum Inter leukin-2 and Inter leukin-6 after in patients with severe acute pancreatisitis

目的应用腹腔镜引导置管早期小网膜囊灌洗治疗重症胰腺炎 (SAP) 10例 ,观察在手术前后白介素 2 (IL2 )和白介素 6 (IL6)的变化以及其他与机体全身过度炎症反应综合症 (SIRS)相关因素的变化。方法 10例SAP于确诊后 2 4h内行腹腔镜引导小网膜孔置管引流术测定手术前及术后2 4h时IL2 和IL6的变化情况 ,同时观察手术前 ,术后 2 4h和术后 4 8h时患者体温 (T)、脉搏 (P)、呼吸(R)、白细胞计数 (WBC)及动脉血二氧化碳分压 (PaCO2 )变化情况并作统计分析。结果 10例SAP血清中炎促因子IL6在行腹腔镜引导小网膜孔置管引流术后 2 4h有降低但差异无显著性 (P >0 .1) ;血清中抗炎因子IL2 在术后 2 4h则升高 ,差异有非常显著性 (P <0 .0 0 1)。患者T、P、R、WBC及PaCO2在术后 2 4h时变化差异无显著性 (P >0 .1) ,在术后 4 8h时变化差异有显著性 (P <0 .0 5 )。结论腹腔镜引导置管早期小网膜囊灌洗治疗重症胰腺炎有利于抑制机体全身过度反应综合症 ,并促进机体抗炎反应综合症。

Objective To observe the thetapeutic effective of application Laparoscopy surgery leading lesser omentum lavation and observe the change of serum interleukn-2, interleukin-6 and factor of systemic inflammatory response syndrome (SIRS) 10 cases of severe acute pancreatitis (SAP) before and after the laparoscopy surgery. Methods Ten patients with SAP were put tube at lesser omentum by Laparoscopy operation. In 24 hours, then the concentrations of serum IL-2 and IL-6 were measured before and after operation. Results The serum IL-2 level was siginificantly increase after operation 24 hours than those before operation (P>0.001). There were no change at T, P, R, WBC, Paco2 for 10 cases after operation 24 hours(P>0.1), but there were significantly change after operation 48 hours(P<0.05).Conclusion The early used of laparoscopy surgery leading lesser omentum lavation will obvious effect in patients with SAP.