腹腔镜与开腹手术阑尾切除患者血清PRE、RbP、CRP和IL-6测定及其临床意义  

Clinical Significance of Changes of Determination on Serum PRE,RbP,CRP and IL-6 Levels by Laparoscopic and Laparotomy Operation Mode in Patients with Appendectomy

作　　者：温占朝[1,2] 朱静 

机构地区：[1]扬州大学第五临床医学院 [2]常熟市二院普外科,215500 [3]常熟市二院核医学科,215500

出　　处：《放射免疫学杂志》2013年第5期557-560,共4页Journal of Radioimmanology

摘　　要：目的:探讨不同手术方式对阑尾切除患者临床及血清八项指标水平的变化,为临床手术方式的择优提供有价值的实验室依据。方法:本文根据课题要求将60例阑尾切除患者设置为两组:即腹腔镜手术组(n=30)和开腹手术组(n=30)及健康者作对照组(n=34)进行分析。血清前白蛋白(prealbumin,PRE)和视黄醇结合蛋白(retinal-binding protein,RbP)测定采用免疫散射比浊法,C-反应蛋白(C-reactive protein,CRP)和白细胞介素6(interleukin-6,IL-6)测定采用放射免疫分析。结果:开腹手术组与腹腔镜手术组临床四项资料比较皆无统计学差异(均P>0.05)。两组患者手术前RbP和PRE二项内脏蛋白指标水平略低于正常对照组,但无显著统计学差异(P>0.05),二项炎性介质水平均显著高于正常对照组(P均<0.05)。手术后1d RbP和PRE二项内脏蛋白指标水平开腹手术组均显著低于正常对照组(P<0.05,P<0.01),腹腔镜手术组水平则略有下降,但无显著统计学差异(P>0.05),两手术组间比较开腹手术组水平显著低于腹腔镜手术组(P均<0.05)。二项炎性介质水平两手术组均显著高于正常对照组(P<0.05,P<0.01),两手术组间比较开腹手术组水平显著高于腹腔镜手术组(P均<0.05)。术后3d RbP和PRE二项内脏蛋白指标水平两手术组均显著低于正常对照组(P<0.05,P<0.01),而两手术组间比较则开腹手术组水平显著低于腹腔镜手术组(P均<0.05)。二项炎性介质水平两手术组均显著高于正常对照组(P<0.05,P<0.01),两手术组间比较开腹手术组水平显著高于腹腔镜手术组(P均<0.05)。开腹手术组和腹腔镜手术组二项内脏蛋白水平术后3d均显著低于术后1d(P<0.05,P<0.01),二项炎性介质水平术后3d也显著低于术后1d(P均<0.05)。结论:二项内脏蛋白和炎性介质水平的变化表明,腹腔镜手术方式的应激反应较开腹手术要轻,建议临床应优先选择这项手术方式。Objective To explore the changes on serum visceral protein and inflammatory indexes levels in serum by laparoscopic and laparotomy operation mode on appendectomy patients. Methods Their serum levels of PRE and RbP （with inununenephelome- try）, CRP （with EIA）, and IL-6 （with RIA） levels were determined in laparoscopic operation patients group （n = 30）, laparotomy op- eration group（ n = 30） and healthy individuals served as control group （n = 34）. Results Clinical results showed, four indexes levels all and singular expressed no significant difference in laparotomy operation patients group than those in laparoscopic operation group （ all P 〉 0.05）. Before the operation, two operation patients group 2 visceral protein levels were only slightly lower, but no significant difference than the control group （all P 〉 0.05 ）. However,2 serum inflanunatory markers presented obviously higher in two operation group than the control group（ all P 〈0.01 ）. 1 day after the surgery, laparotomy operation group 2 visceral protein levels indicated sig- nificantly lowe rthan the control group （P 〈 0.05 ,P 〈 0.01 ）, only slightly lower in laparoscopic, operation patients group than the con- trol group, but no significant difference than the control group （ all P 〉 0.05 ）. while, 2 serum inflammatory markers kept remarkably higher in two operation mode group than the control group（ all P 〈 0.01 ）. Comparison between the two groups of operation, there re- mained significant differences in four serum observation indicators （ all P 〈 0.05 ）. 3days after the operation, laparotomy operation group 2 visceral protein levels were significantly lower than the control group （ P 〈 0.05, P 〈 0.01 ）, 2 serum inflammatory markers were significantly higher in two operation group than the control group（ all P 〈0.01 ）. Comparison between the two groups of operation, there remained significant differences in four serum indicators （ all P 〈 0.05）. Comparison between th

关 键 词：急性阑尾炎腹腔镜前白蛋白视黄醇结合蛋白 C-反应蛋白 白细胞介素6 

分 类 号：R656[医药卫生—外科学]