急性重症胆管炎外科治疗及相关指标与预后的关系

The Surgical Therapy of Acute Cholangitis of Severe Type and the Relation of Correlated Indices for Prognosis

目的:本实验通过对急性重症胆管炎(ACST)患者的临床表现及手术治疗前后不同时期血清中TNF-α、IL-1和LI-6含量的测定,分析急性重症胆管炎患者及时有效实施手术的重要意义及相关指标对预后的提示作用。方法:选取我院2011年10月至2012年3月住院并接受外科手术治疗的ACST患者42例,分析患者的临床资料及手术方式;并根据治疗效果分为治愈组31例和未治愈组11例,分别于术中、术后7d、14d检测患者血清中TNF-α、IL-1和LI-6含量,同时选取30例健康自愿者的血清作为对照组。结果:术中42例急性重症胆管炎患者血清中TNF-α、IL-1和LI-6含量明显高于对照组,差异有统计学意义(P<0.01)。术后7d治愈组血清中TNF-α和IL-1的含量低于未治愈组,但差异无统计学意义(P>0.05),血清中LI-6的含量明显低于未治愈组,差异有统计学意义(P<0.05);术后14d治愈组血清中TNF-α、IL-1和LI-6的含量明显低于未治愈组,差异有统计学意义(P<0.01)。结论:及时诊断、早期治疗是急性重症胆管炎患者手术成功的关键,血清中TNF-α、IL-1和LI-6含量的检测对急性重症胆管炎的诊断及预后有重要的提示作用。

Objective： To observe the clinical situation of acute cholangitis of severe type and test the content of TNF-α, IL- 1 and LI-6 which in different period before and after operation, analyze the important of performing ACST operation promptly and the indication of correlated indices for prognosis. Method： Selected 42 ACST patients accepted operation , analysed their clinical data and modus operandi ;and divided into cure group and null group by therapeutic efficacy, detect the content of TNF-α, IL-1 and LI-6 in patients serum respectively , selected 30 healthy volunteers as a control group. Result： The content of TNF-α, IL- 1 and LI-6 in 42 ACST patients during operation were higher than the control group, There＇s remarkable significance （ P〈0.05 ）, the content of TNF-α and IL- 1 in cure group after operation 7 days were lower than the null group, There＇s no remarkable significance （ P〉0.05 ）, but the content of LI-6 was higher than the null group have remarkable significance （P〈0.05 ） ; the content of TNF-α, IL-1 and LI-6 in cure group after operation 14 days were lower than the null group, have remarkable significance （ P〈0.01 ）. Conclusion： Early 1 and diagnosis and appropriate treatment is key point for success of ACST operation, the test of TNF-α, IL- LI-6 in serum has important index effect for the diagnose and prognosis of ACST.