胸腔镜手术对小儿纵隔肿瘤术后感染及疼痛应激相关血液指标的影响研究  

Influence of thoracoscopic surgery on the postoperative infection and pain stress related blood indexes of children with mediastinal tumor

作　　者：吴强[1] 宋非无[1] 黄河[1] 许雅丽[1] 陈兴和[1] WU Qiang SONG Fei-wu HUANG He XU Ya-li CHEN Xing-he(The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350004, Chin)

机构地区：[1]福建医科大学附属第一医院小儿外科,福建福州350004

出　　处：《中华医院感染学杂志》2017年第4期927-930,共4页Chinese Journal of Nosocomiology

基　　金：福建省卫生厅青年科研课题(2010-2-34)

摘　　要：目的研究胸腔镜手术对小儿纵隔肿瘤术后感染及疼痛应激相关血液指标的影响,以了解该类手术的临床应用价值。方法选取2012年1月-2016年1月于医院进行手术治疗的纵隔肿瘤患儿64例为研究对象,将其随机分为对照组和观察组,每组各32例,对照组患儿进行传统开胸手术治疗,观察组患儿则进行胸腔镜手术治疗,统计比较两组患儿的术后感染率、术前及术后疼痛应激相关血液指标。结果观察组患儿术后的感染率为3.13%,明显低于对照组12.50%;术前两组手术患儿致痛介质5-HT、PGE2、BK及NPY血清表达水平比较,差异无统计学意义,而术后12与24h观察组手术患儿致痛介质5-HT、PGE2、BK及NPY血清表达水平均低于对照组,差异有统计学意义(P<0.05);术前两组手术患儿其他疼痛应激指标NO、IL-1β及IL-6血清表达水平比较,差异无统计学意义,而术后12与24h观察组手术患儿其他疼痛应激指标NO、IL-1β及IL-6血清表达水平均低于对照组,差异有统计学意义(P<0.05)。结论胸腔镜手术对小儿纵隔肿瘤术后感染及疼痛应激相关血液指标的控制效果较好,因此该术式更为适用于纵隔肿瘤患儿,临床应用价值较高。OBJECTIVE To study the impact of thoracoscopic surgery on the postoperative infection and pain stress related blood indexes of children with mediastinal tumor,in order to understand the clinical application value of the surgery.METHODS A total of 64 children with mediastinal tumor who were treated with surgery in our hospital from Jan.2012 to Jan.2016 were selected as study objects,and were randomly divided into control group and observation group,with 32 cases in each group.Children of control group were treated with traditional open chest surgery,and of observation group were treated with thoracoscopic surgery,then the postoperative infection rates,pain stress related blood indexes before and after the surgery of the two groups were analyzed and compared.RESULTS The total postoperative infection rate of observation group was 3.13%,which was lower than 12.50%of control group.The pain stress related blood indexes of 5-HT,PGE2,BK,and NPY of the two groups before the surgery had no significant difference.At 12 and 24hour after the surgery,the pain stress related blood indexes of5-HT,PGE2,BK,and NPY of observation group were all significantly lower than those of control group,the differences of two groups were all significant（all P〈0.05）.The other pain stress related blood indexes of NO,IL-1βand IL-6of the two groups before the surgery had no significant difference.At 12 and 24hour after the surgery,the pain stress related blood indexes of NO,IL-1βand IL-6of observation group were all significantly lower than those of control group,the differences of two groups were all significant（all P0.05）.CONCLUSION The control effect of thoracoscopic surgery for the postoperative infection and pain stress related blood indexes of children with mediastinal tumor is better,so the surgery method is more suitable for the children with mediastinal tumor,and its clinical application value is higher.

关 键 词：胸腔镜手术 小儿纵隔肿瘤 术后感染 疼痛应激相关血液指标 

分 类 号：R726.1[医药卫生—儿科]