腹腔镜对急性阑尾炎腹内感染患儿炎症因子水平和免疫功能的临床影响研究  

Clinical effect of laparoscope on inflammatory factors levels and immune function of children with acute appendicitis intra-abdominal infections

作　　者：王军 曹斌校 李绍刚 林寒冰 王东海 陈桂东 唐龙欢 

机构地区：[1]奉化市人民医院普外科,浙江宁波315500

出　　处：《中华医院感染学杂志》2016年第22期5213-5215,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2013KYA192);宁波科技局一般课题基金资助项目(2010A21)

摘　　要：目的 探讨腹腔镜及二氧化碳气腹对急性阑尾炎腹内感染患儿炎症因子水平和免疫功能的临床影响,为急性阑尾炎腹内感染的临床诊治提供依据。方法 选取2014年12月-2015年10月医院收治的急性阑尾炎腹内感染患儿88例,根据患者手术治疗分成研究组和对照组,各44例,研究组给予腹腔镜手术,对照组给予传统开腹手术,观察和比较两组患儿手术切口感染率、腹腔脓肿发生率、白细胞总数（WBC）、中性粒细胞（N）、淋巴细胞（L）计数、C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）等指标水平。结果 研究组患儿术后切口感染率和腹腔脓肿发生率分别为0和2.27%,低于对照组9.09%和18.18%;术后研究组患儿CRP和TNF-α水平分别为（23.98±17.34）mg/l和（1.11±0.34）ng/ml,低于对照组（39.07±19.35）mg/l和（1.54±0.64）ng/ml;术后研究组患儿WBC、N和L水平分别为（10.76±1.35）×10^9/L、（7.67±1.64）×10^9/L、（1.86±0.65）×10^9/L,低于对照组的（15.43±2.91）×10^9/L、（12.98±3.21）×10^9/L、（2.36±1.34）×10^9/L,且差异有统计学意义（P〈0.05）。结论 在临床手术治疗急性阑尾炎腹内感染的实践过程中,与开腹手术相比采用腹腔镜手术可有效控制患儿术后感染,改善患儿炎症因子和免疫功能,是临床手术过程中的理想选择。OBJECTIVE To explore the clinical effects of laparoscope and carbon dioxide pneumoperitoneum on in‐flammatory factors levels and immune function of children with acute appendicitis intra‐abdominal infections so as to provide guidance for clinical diagnosis and treatment of the acute appendicitis intra‐abdominal infections . METHODS A total of 88 children with acute appendicitis intra‐abdominal infections who were treated in the hospi‐tal from Dec 2014 to Oct 2015 were enrolled in the study and divided into the study group and the control group ac‐cording to the surgical procedure ,with 44 cases in each group .The study group was treated with laparoscopic sur‐gery ,and the control group was given the conventional laparotomy .The incidence of surgical incision infection , incidence of intra‐abdominal abscess ,total white blood cell （WBC） counts ,neutrophils （N） ,and lymphocytes （L） counts as well as levels of C‐reactive protein （CRP） and tumor necrosis factor‐α（TNF‐α） were observed and com‐pared between the two groups of children .RESULTS The incidence of postoperative incision infection of the study group was 0% ,lower than 9 .09% of the control group;the incidence of intra‐abdominal abscess of the study group was 2 .27% ,lower than 18 .18% of the control group .The postoperative CRP level of the study group was （23 .98 ± 17 .34）mg/l ,lower than （39 .07 ± 19 .35）mg/l of the control group ;the postoperative TNF‐αlevel of the study group was （1 .11 ± 0 .34）ng/ml ,lower than （1 .54 ± 0 .64）ng/ml of the control group .The postoperative WBC level of the study group was （10 .76 ± 1 .35） × 10^9/L ,lower than （15 .43 ± 2 .91） × 10^9/L of the control group;the postoperative N level of the study group was （7 .67 ± 1 .64）× 10^9/L ,lower than （12 .98 ± 3 .21）× 10^9/L of the control group;the postoperative L level of the study group was （1 .86 ± 0 .65）× 10^9/L ,lower than （2 .36 ± 1 .34）× 10^9/L of the control group ,and

关 键 词：腹腔镜 二氧化碳气腹 急性阑尾炎腹内感染 炎症因子 免疫功能 

分 类 号：R574.61[医药卫生—消化系统]