腹腔镜治疗腹股沟斜疝对小儿血IL-1β、免疫球蛋白的影响

Effect of laparoscopic repare of inguinal hernia on the changes of cytokine IL-1β、IgM、IgA、IgG in children

目的:探讨腹腔镜治疗小儿腹股沟斜疝手术前后对外周血白介素-1β(IL-1β)、免疫球蛋白A、G、M(IgA、IgG、IgM)的变化。方法:将50例腹股沟斜疝的患儿按抽签方式,分为腹腔镜组和开放组各25例。腹腔镜组行腹腔内环口疝囊结扎术;开放组行腹股沟部切开疝囊高位结扎。于手术前1天早晨空腹、术后即刻、手术后第2天早晨空腹采外周静脉血,用ELISA法测定血浆中的IL-1β、IgM、IgA、IgG的含量。结果:2组术后即刻IL-1β、IgM、IgA、IgG比手术前均有显著升高(腹腔镜组q=11.307、22.111、24.161、23.111、P<0.05;开放组q=16.668、21.707、23.707、22.707,P<0.05);但开放组上述指标明显高于腹腔镜组(t=-4.509、P=0.000;t=-4.745、P=0.000;t=5.745、P=0.000;t=-6.745、P=0.000)。术后第2天,与术前相比腹腔镜组IL-1β、IgM、IgA、IgG,差异无显著性(q=0.482、3.853、4.653、4.853,P>0.05);而开放组仍高于术前(q=10.599、11.379、10.768、12.379,P<0.05)。2组相比,开放组明显高于腹腔镜组(t=-5.051、P=0.000;t=-3.730、P=0.001;t=-4.430、P=0.001;t=-5.530、P=0.001)。结论:与开放手术治疗相比,腹腔镜治疗腹股沟斜疝引起IL-1β、Ig改变的较小,因而,腹腔镜手术对小儿机体的免疫抑制作用小,持续时间短。

Objective:To explore effects of laparoscopic surgery(LS) and open surgery(OS) repair of inguinal hernia on theIL-1β,Ig in children.Methods:Fifty children with inguinal hernia were assigned to undergo repair of inguinal hernia,either by laparoscopic procedure or by open procedure.Blood samples for IL-1β,IgM、IgA、IgG were collected in tubes as follows:a day before surgery,surgery ending,2 days after surgery.Serum level of,IL-1β was determined by ELISA.IgM、IgA、IgG in peripheral blood was determined by Immunization rates scattering Turbidimetry.Results:The level of IL-1β,and IgM、IgA、IgG at the point of surgery ending in both groups increased significantly than those at before operation(LS Group:=11.307、22.111、24.161、23.111、P<0.05;OS Group:q=16.668、21.707、23.707、22.707,P< 0.05),and were significantly higher in OS Group than in LS Group(t=-4.509、P=0.000;t=-4.745、P=0.000;t=5.745、P=0.000;t=-6.745、P=0.000.As compared with preoperative levels,the level of IL-1β and IgA、IgG、IgM at 2 days after operation were not significance in the LS Group(q = 0.482、3.853、4.653、4.853,P>0.05)and were significantly higher in OS Group(q = 10.599、11.379、 10.768、12.379,P<0.05).and were significantly higher in OS Group than in LS Group(t=-5.051、P=0.000;t=-3.730、P=0.001;t=-4.430、P=0.001;t=-5.530、P=0.001).Conclusions:Laparoscopic surgery in repairing inguinal hernia causes smaller alteration in IL-1β、IgA、IgG、IgM than open surgery.Laparoscopic surgery is markedly less stressful,with small immunoinhibition and short durative time in the early time after operation than open surgery in children.