恶性梗阻性黄疸患者血清内毒素和肿瘤坏死因子的检测

Serum endotoxin and TNF levels in patients with malignant obstructive jaundice

目的 探讨恶性梗阻性黄疸病人不同引流术式对血清内毒素 (ET )及肿瘤坏死因子 (TNF)水平的影响。方法 测量 36例恶性梗阻性黄疸病人内外引流术的手术前术后血清ET和TNF水平。结果 胆肠吻合内引流术 10d后ET和TNF较术前明显降低 (P <0 .0 1) ,而外引流组则术前术后无显著变化 (P >0 .0 5 )。术前两组差异无显著性 (P >0 .0 5 ) ,手术 10d后内引流组显著低于外引流组(P <0 .0 1)。结论 尽管内外引流均可使黄疸减退 ,但内引流术能更有效地降低血清ET和TNF水平 ,因此 。

Objective To study the influence of different drainage operation on the serum endotoxin (ET) and tumor necrosis factor (TNF) levels in patients with malignant obstructive jaundice (MOJ). Methods ET and TNF levels of 36 patients with MOJ were measured before and after cholangiojejunostomy (CJ) or external bile drainage (EBD). Results In CJ group, serum ET and TNF levels 10 days after the operation were significantly lower than those before the operation(P<0.01). In EBD group, there were no significant differences in ET and TNF levels between the preoperative and postoperative test(P>0.05). There were no significant differences between these two groups preoperatively(P>0.05), but the values of ET and TNF in the CJ group were significantly lower than those in the EBD group (P<0.01)postoperatively. Conclusions CJ can decrease the serum ET and TNF more effectively than EBD, though both of them can release the jaundice. So, CJ should be adopted as possible to the patients with unresectable malignant tumor.