腹腔镜手术患儿围手术期血清细胞因子的变化及其意义(英文)  

Change and significance of perioperative cytokine levels in children undergoing laparoscopy

作　　者：王禾[1] 王龙信[1] 秦卫军[1] 田丰[1] 袁建林[1] 刘贺亮[1] 杨晓剑[1] 李欣[1] 于磊[1] 张更[1] 

机构地区：[1]解放军第四军医大学西京医院泌尿外科,陕西省西安市710032

出　　处：《中国组织工程研究与临床康复》2007年第45期9209-9212,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家"十五"攻关课题资助项目(2004BA720A12)~~

摘　　要：背景:腹腔镜手术比起开放手术有创伤小,应激反应轻,术后恢复快的优势,而对于腹腔镜手术后细胞因子水平的变化研究不一,目前,对于小儿腹腔镜围手术期细胞因子的变化报道不多,尚无定论。目的:比较小儿腹腔镜与开腹手术围手术期血清细胞因子水平的变化及临床意义。设计:非随机化同期对照观察。单位:解放军第四军医大学西京医院泌尿外科。对象:选择2004-05/2006-12在解放军第四军医大学西京医院泌尿外科就诊的小儿外科择期手术病例135例,其中腹行腔镜手术患儿65例,行非腹腔镜开放手术患儿70例。方法:检测其术前24h及术后3,24,48h血清白细胞介素1β、白细胞介素6、白细胞介素10和肿瘤坏死因子α水平变化,并记录其住院时间。主要观察指标:两组患者术前24h,术后3,24,48h的血清细胞因子白细胞介素1β、白细胞介素6、白细胞介素10和肿瘤坏死因子α水平变化。结果:135例均进入结果分析。①细胞因子变化:腹腔镜手术组手术前后各细胞因子均无显著变化(P>0.05),而非腹腔镜开放手术组白细胞介素1β、白细胞介素6术后3,24h均有明显升高(P<0.05),术后48h开始回落,而白细胞介素10、肿瘤坏死因子α变化不明显(P>0.05)。非腹腔镜开放手术组术后24h白细胞介素1β、白细胞介素6水平高于腹腔镜手术组(P<0.05)。②住院时间:腹腔镜手术组短于非腹腔镜开放手术组[(3.5±1.0),(7.5±1.5)d,P<0.05]。结论:与开放手术相比,小儿腹腔镜手术对血清细胞因子水平影响小,术后恢复快。BACKGROUND：The laparoscopy is superior to open surgery for being less invasive, inducing mild stress reaction and allowing quick recovery after operation, however the effects of laparoscopy on perioperative serum cytokine levels are controversial, and only a few studies discuss these effects among pediatric patients. OBJECTIVE： To compare the changes in perioperative cytokine levels and their clinical significance in pediatric patients undergoing laparoscopy and open surgery. DESIGN ： Non-randomized concurrent controlled observation. SEI-FING ： Department of Urology in Xijing Hospital of the Fourth Military Medical University of Chinese PLA. PARTICIPANTS： From May 2004 to December 2006, 135 pediatric patients for elective operation were recruited from Department of Urology in Xijing Hospital of the Fourth Military Medical University of Chinese PLA. Sixty-five patients were scheduled for laparoscopic surgery while the remaining 70 patients for open surgery. METHODS Serum levels of interleukin-1 beta （IL-1i3）, IL-6, IL-10 and tumor necrosis factor-alpha （TNF-α） were measured at 24 hours before operation, and 3, 24, 48 hours after operation respectively. Duration of hospitalization time of all the children was also recorded. MAIN OUTCOME MEASURES： Levels of IL-Iβ, IL-6, IL-10 and TNF-α of all the patients were measured 24 hours preoperatively, and 3, 24, 48 hours postoperatively. RESULTS ： All the 135 cases were included for statistical analysis. ①There were no significant perioperative changes in cytokine levels after laparoscopic surgery （P 〉 0.05）. In the open surgery group, IL-1β and IL-6 levels increased significantly at 3 and 24 hours after operation （P 〈 0.05）, and normalized within 48 hours postoperatively. No significant perioperative differences were found in IL-10 and TNF-α levels （P 〉 0.05）. The levels of IL-113 and IL-6 were significantly higher in the open surgery group than in the laparoscopic surgery group （P 〈 0.05）. ②Duration of hospitali

关 键 词：腹腔镜 细胞因子 围手术期 儿童 

分 类 号：R392.114[医药卫生—免疫学]