中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
2期
150-152
,共3页
刘柏春%曾跃红%田海清%李龙平
劉柏春%曾躍紅%田海清%李龍平
류백춘%증약홍%전해청%리룡평
急性阑尾炎%阑尾切除术%腹腔镜%炎症反应
急性闌尾炎%闌尾切除術%腹腔鏡%炎癥反應
급성란미염%란미절제술%복강경%염증반응
Acute appendicitis%Appendectomy%Laparoscopy%Inflammation
目的 比较腹腔镜与开腹阑尾切除术对机体炎症的影响.方法 160例急性阑尾炎患者采用抽签方式分为腹腔镜阑尾切除术组(LA组)和开腹阑尾切除术组(OA组),各80例,分别采用LA及OA术式手术.分别于术前和术后1、3d检测2组患者的外周血C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和白细胞计数(WBC),并进行对比分析,同时比较2组患者的手术时间、术后肠道功能恢复时间、住院时间、住院费用及术后并发症发生情况.结果 LA组的肠功能恢复时间[(12.8±5.8)d]和住院时间[(4.6±1.4)d]明显低于OA组[(27.6±9.6)d与(6.7±1.1)d],差异有统计学意义(t=11.802,10.550,均P<0.01).LA组术后1 d和3 d的CRP[(58.4±24.6)mg/L、(25.1±12.7)mg/L]、IL-6[(31.12±10.45)ng/L、(22.32±7.58)ng/L]、TNF-α[(1.11±0.31)mg/L、(0.98±0.39)mg/L]和WBC[(10.13±1.84)×10~9/L、(8.29±2.66)×10~9/L]水平明显低于OA组[CRP:(91.7±42.3)mg/L、(41.7±24.6)mg/L,IL-6:(58.21±11.26)ng/L、(39.77±8.24)ng/L,TNF-α:(1.72±0.44)mg/L、(1.29±0.47)mg/L,WBC:(15.6±2.48)×10~9/L、(12.3±2.72)×10~9/L],差异有统计学意义(术后1 d:t=6.087,15.773,10.137,15.843,术后3 d:t=5.363,13.940,4.540,9.427,均P<0.01).2组患者术后均无并发症发生.结论 LA治疗急性阑尾炎比OA对机体损伤更小,可有效地保护机体免疫功能,有利于术后快速康复.
目的 比較腹腔鏡與開腹闌尾切除術對機體炎癥的影響.方法 160例急性闌尾炎患者採用抽籤方式分為腹腔鏡闌尾切除術組(LA組)和開腹闌尾切除術組(OA組),各80例,分彆採用LA及OA術式手術.分彆于術前和術後1、3d檢測2組患者的外週血C反應蛋白(CRP)、白細胞介素6(IL-6)、腫瘤壞死因子α(TNF-α)和白細胞計數(WBC),併進行對比分析,同時比較2組患者的手術時間、術後腸道功能恢複時間、住院時間、住院費用及術後併髮癥髮生情況.結果 LA組的腸功能恢複時間[(12.8±5.8)d]和住院時間[(4.6±1.4)d]明顯低于OA組[(27.6±9.6)d與(6.7±1.1)d],差異有統計學意義(t=11.802,10.550,均P<0.01).LA組術後1 d和3 d的CRP[(58.4±24.6)mg/L、(25.1±12.7)mg/L]、IL-6[(31.12±10.45)ng/L、(22.32±7.58)ng/L]、TNF-α[(1.11±0.31)mg/L、(0.98±0.39)mg/L]和WBC[(10.13±1.84)×10~9/L、(8.29±2.66)×10~9/L]水平明顯低于OA組[CRP:(91.7±42.3)mg/L、(41.7±24.6)mg/L,IL-6:(58.21±11.26)ng/L、(39.77±8.24)ng/L,TNF-α:(1.72±0.44)mg/L、(1.29±0.47)mg/L,WBC:(15.6±2.48)×10~9/L、(12.3±2.72)×10~9/L],差異有統計學意義(術後1 d:t=6.087,15.773,10.137,15.843,術後3 d:t=5.363,13.940,4.540,9.427,均P<0.01).2組患者術後均無併髮癥髮生.結論 LA治療急性闌尾炎比OA對機體損傷更小,可有效地保護機體免疫功能,有利于術後快速康複.
목적 비교복강경여개복란미절제술대궤체염증적영향.방법 160례급성란미염환자채용추첨방식분위복강경란미절제술조(LA조)화개복란미절제술조(OA조),각80례,분별채용LA급OA술식수술.분별우술전화술후1、3d검측2조환자적외주혈C반응단백(CRP)、백세포개소6(IL-6)、종류배사인자α(TNF-α)화백세포계수(WBC),병진행대비분석,동시비교2조환자적수술시간、술후장도공능회복시간、주원시간、주원비용급술후병발증발생정황.결과 LA조적장공능회복시간[(12.8±5.8)d]화주원시간[(4.6±1.4)d]명현저우OA조[(27.6±9.6)d여(6.7±1.1)d],차이유통계학의의(t=11.802,10.550,균P<0.01).LA조술후1 d화3 d적CRP[(58.4±24.6)mg/L、(25.1±12.7)mg/L]、IL-6[(31.12±10.45)ng/L、(22.32±7.58)ng/L]、TNF-α[(1.11±0.31)mg/L、(0.98±0.39)mg/L]화WBC[(10.13±1.84)×10~9/L、(8.29±2.66)×10~9/L]수평명현저우OA조[CRP:(91.7±42.3)mg/L、(41.7±24.6)mg/L,IL-6:(58.21±11.26)ng/L、(39.77±8.24)ng/L,TNF-α:(1.72±0.44)mg/L、(1.29±0.47)mg/L,WBC:(15.6±2.48)×10~9/L、(12.3±2.72)×10~9/L],차이유통계학의의(술후1 d:t=6.087,15.773,10.137,15.843,술후3 d:t=5.363,13.940,4.540,9.427,균P<0.01).2조환자술후균무병발증발생.결론 LA치료급성란미염비OA대궤체손상경소,가유효지보호궤체면역공능,유리우술후쾌속강복.
Objective To investigate the different influence of laparoscopic appendectomy and open appen-dectomy on inflammation. Methods A total of 160 cases of acute appendicitis were randomly divided into the lapa-roscopic appendectomy (LA group) and open appendectomy group (OA group). Each included 80 cases. The lev-els of CRP, IL-6, TNF alpha and WBC were measured before operation, 1, 3 day after operation were recorded. Operative duration, postoperative time for intestinal function recovery, hospital stay, hospital cost and postoperative complications were also compared between the two groups. Results The intestinal function recovery time and hospi-tal stay were markedly shorter in the LA group than in the OA group (P < 0.01). The circulating levels of the CRP, IL-6, TNF alpha and WBC were lower 1 and 3 days after operation in the LA group than those in the OA group (all P < 0.01). No complications occured in the two groups. Conclusion LA proves to have less impact on body injury than LA by protecting the immune function and assisting in the postoperative recovery.
