经肛门手术与传统剖腹手术对巨结肠患儿术后应激反应的对比研究  

Comparison of laparotomy and transanal pull-through operation for the surgical stress in the treatment of Hischsprung's disease

作　　者：陆如纲[1] 易军[1] 刘继炎[1] 张儒仿[2] 

机构地区：[1]南京医科大学附属南京儿童医院普外科,江苏南京210008 [2]南京医科大学附属南京儿童医院心胸外科,江苏南京210008

出　　处：《南京医科大学学报（自然科学版）》2007年第7期751-753,共3页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京医科大学科技发展基金资助项目(NY0570)

摘　　要：目的:探讨经肛门巨结肠根治术与传统剖腹手术对先天性巨结肠患儿手术创伤程度的差别。方法:30例患儿随机分为经肛门组及剖腹手术组各15例。每例患儿于术前24h、术后24h、72h清晨空腹抽取静脉血,用ELISA法测量血清中IL-6的浓度,应用速率散射比浊法测量C反应蛋白的浓度,并对检测结果进行统计学处理。结果:两组患儿术后白细胞介素-6(IL-6)及C反应蛋白均较术前有明显变化(P<0.05)。经肛门组IL-6、C反应蛋白浓度在术后24h及72h均较剖腹组要低(P<0.05)。结论:经肛门巨结肠根治术较传统剖腹手术对先天性巨结肠患儿所造成的手术创伤程度要小。Objective：To make a comprasion in surgical stress between laparotomy and transanal pull-throug operation on Hischsprung＇s disease （HD） in children. Methods：Thirty patients were randomly divided into laparotomy group （n= 15 ） and transanal pullthrough group （n=15）. The blood was collected in the morning before operation, 24 and 72 h postoperation. Plasma levels of IL-6 were determined by ELISA,and C-reaction protein （CRP） levels were measured by immune rate nephelometry. Methods：The statistical difference before and after surgery was analyzed by SPSS software. Results：There were significant difference in plasma levels of IL-6 and CRP before and after surgery （P 〈 0.05 ）. The transanal pull-through group showed lower level of IL-6 and CRP on 24 and 72 h postoperation than laparotomy group（P 〈 0.05 ）. Conelusion：Transanal pull-through operation causes less surgical stress than laparotomy on HD.

关 键 词：巨结肠 先天性 白细胞介素-6 C反应蛋白 儿童 

分 类 号：R657.1[医药卫生—外科学]