腹股沟疝嵌顿患者血清内毒素水平的临床监测分析

Clinical significance of monitoring serum endotoxin level in patients with groin femoral hernia

目的探讨血清内毒素与腹股沟疝嵌顿患者急诊行手法复位成功率及手法复位并发症发生率的关系。方法以腹股沟疝嵌顿患者急诊成功行手法复位的为A组（n=64），未成功行手法复位的为B组（n=32）。B组中急诊手术治疗术中证实手法复位未出现并发症的为C组（n=26），出现并发症的为D组（n=6），由鲎三肽基质显色法测血清内毒素水平。结果A组腹股沟疝嵌顿患者血清内毒素水平（14．23±5．3）Eu／L较B组低（t=12．14，P〈0．05），C组腹股沟疝嵌顿患者血清内毒素水平（27．5±8．2）Eu／L较D组低（t=10．46，P〈0．05）。结论血清内毒素水平与腹股沟疝嵌顿患者急诊手法复位成功率密切相关，与手法复位并发症发生率密切相关，可作为判断能否行手法复位有用指标。

Objective To investigate the relationship between serum endotoxin and sueeessful rate of emer- gency manipulative reduction, the incidence rate of complications in patients with incarcerated groin hernias. Methods 64 patients with incarcerated groin hernias received successful emergency manipulative reduction were sleeted as group A,32 patients with unsuccessful manual reduction were sleeted as group B. In group B, emergency surgical therapy confirmed no complications enrolled to group C （n = 26）, occurred complications as group D（ n = 6）. The serum level of endotoxin was measured by the limulus tripeptide substrate coloration method. Results The serum endotoxin level of group A （ 14.23 ~ 5.3 ） Eu/L was lower than group B（ t = 12.14 ,P 〈 0.05 ）. The serum endotoxin level of group C （27.5 _＋8.2）Eu/L was lower than group D（t = 10.46,P 〈0.05）. Conclusion Serum level ofen- dotoxin is closely related with the successful rate of emergency manipulative reduction and the incidence rate of com- plications,it is a useful indicator to judge whether the patients are suitable for manipulative reduction.