腹腔镜手术对肠系膜囊肿患儿炎症因子和免疫功能的影响  

Influence of laparoscopic surgery on inflammatory factor and immune function in children with mesenteric cyst

作　　者：蒋文军[1] 曹李明[1] 马俊梅[1] 

机构地区：[1]四川省人民医院儿外科,四川成都610072

出　　处：《海南医学院学报》2015年第10期1381-1383,1386,共4页Journal of Hainan Medical University

基　　金：四川省技术创新资助项目(2013EF00167)~~

摘　　要：目的:探讨腹腔镜手术治疗对肠系膜囊肿患儿炎症因子和免疫功能的影响。方法:回顾性分析小儿外科收治的肠系膜囊肿患儿80例,根据治疗方法的不同将所有患儿分为腹腔镜组(n=45)和开腹组(n=35),开腹组采用开腹手术治疗,腹腔镜组采用腹腔镜手术治疗,分别于术前、术后1d、术后3d和术后7d检测所有患儿血清炎症因子肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和C反应蛋白(CRP)和外周血T细胞亚群CD3+、CD4+、CD8+百分比。结果:术后两组炎症因子TNF-α、IL-6和CRP均呈先升高后下降的趋势(P<0.05),术后各时间点比较,腹腔镜组炎症因子TNF-α、IL-6和CRP均显著低于开腹组(P<0.05);术后两组免疫功能指标CD3+、CD4+均呈先下降后升高的趋势,而CD8+则呈先升高后下降的趋势(P<0.05),术后各时间点比较,腹腔镜组免疫功能指标CD3+、CD4+均高于开腹组,CD8+均低于开腹组,差异均有统计学意义(均P<0.05)。结论:手术治疗小儿肠系膜囊肿会对组织造成损失,引起炎症反应和免疫抑制,腹腔镜手术创伤小,炎症反应和免疫抑制更轻微,且恢复快,值得临床借鉴。Objective： To explore the influence of laparoseopic surgery on inflammatory factor and immune function in children with mesenteric cyst. Methods： A total of 80 cases with mesenteric cyst were randomly divided into laparoscopy group （n=45） and laparotomy group （n=35） according to different treatment methods. Children in laparoscopy group were treated with laparoscopic surgery while children in laparotomy group was treated with open operation. Tumor necrosis factor alpha （TNF-α）, interleukin 6 （IL-6）, c-reactive protein （CRP） and peripheral blood T cell subsets CD3＋ , CD4＋ , CD8＋ percentage before and 1 d, 3 d and 7 d after surgery were detected and compared. Results; The inflammatory factor TNF-α, IL-6 and CRP in two groups after surgery were firstly increased then decreased （P〈0.05）, the inflammatory factor TNF-α, IL-6 and CRP at each time point in laparoscopic group were significantly lower than laparoscopic group （P〈0.05）. The immune function inde- xes CD3＋ , CD4＋ in two groups after surgery were firstly decreased then increased （P〈0.05）, CD8＋ was firstly increased then decreased （P〈0.05）. The immune function indexes CD3＋ ,CD4＋ at each time point in laparoscopic group were signifi- cantly higher than laparoscopic group, CDS＋was significantly lower （P%0.05）. Conclusions： Surgery in the treatment of ped- iatric mesenteric cyst can cause damage to tissue, cause inflammation and immune suppression. Laparoscopic surgery is of little wound, more mild inflammation and immune suppression, and rapid recovery. It is worthy of clinical application.

关 键 词：腹腔镜手术 开腹手术 肠系膜囊肿 炎症因子 免疫功能 儿童 

分 类 号：R735.4[医药卫生—肿瘤]