急性重症胆管炎患者手术前后血清炎性因子的变化及意义

The changes of serum inflammatory factors of patients with acute cholangitis of severe type before and after operation

目的观察急性重症胆管炎患者手术前后血清炎性因子的变化并探讨临床意义。方法选择2012年10月-2014年10月我科收治的急性重症胆管炎患者90例为研究对象,随机分为对照组和观察组,每组45例。对照组:行传统开腹手术;观察组:行腔镜手术。比较两组患者手术前后血清炎性因子白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α),C反应蛋白(CRP)、视黄醇结合蛋白(RBP)的变化。结果两组患者术后血清IL-1、IL-6、CRP、TNF-α均较术前降低,而RBP较术前增高(P<0.05);观察组术后血清炎性细胞因子的变化比对照组更加显著(P<0.05)。结论开腹和腹腔镜手术均能减轻急性重症胆管炎患者的炎性反应,而腔镜手术更有利于患者术后的炎症恢复。

Objective To observe the changes of serum inflammatory factors of patients with acute cholangitis of severe type before and after operation and.to explore the clinical significance.Methods 90 acute cholangitis of severe type cases were selected as study objects in our hospital from 2012 October to 2014 October.The patients were divided into control group and observation group randomly.Each group has 45 cases.The control group was underwent open abdominal operation.The observation group was underwent laparoscopic operation.The serum inflammatory factors：IL-1,IL-6,TNF-α,CRP and RBP was compared before and after operation.Results The IL-1,IL-6,CRP and TNF-αof two group after operation was lower than that of before operation,but RBP was higher than that of before operation（P〈0.05）.The serum inflammatory factors of observation group after operation was more significant than that of control group（P〈0.05）.Conclusion Open abdominal and laparoscopic operation can both relieve the inflammatory reaction of acute cholangitis patients.Laparoscopic operation is more favorable to the recovery of inflammation.