腹腔镜治疗对急性化脓性阑尾炎患儿血清slCAM-1与IL-8和TNF-α水平及免疫功能的影响  

Impact of laparoscopy of levels of serum slCAM-1,IL-8,TNF-α and immune function of children with acute suppurative appendicitis

作　　者：段春胜[1] 周丽霞[1] 王军辉[1] 朱旭光[1] 李媛[1] 

机构地区：[1]邢台市人民医院小儿外科,河北邢台054000

出　　处：《中华医院感染学杂志》2017年第14期3323-3326,共4页Chinese Journal of Nosocomiology

摘　　要：目的研究腹腔镜治疗小儿急性化脓感染阑尾炎患者的血清可溶性细胞间粘附分子1(slCAM-1)、白细胞介素8(IL-8)以及肿瘤坏死因子-α(TNF-α)指标变化和对免疫功能影响的分析。方法选取2014年2月-2016年8月医院治疗的急性化脓感染的阑尾炎患儿213例,根据不同的治疗方案分为两组,对照组106例患者采用传统开腹手术治疗,观察组107例患者采用腹腔镜手术,治疗1周后比较两组患儿在治疗前后的血清slCAM-1、白细胞介素8(IL-8)以及肿瘤坏死因子-α(TNF-α)炎性指标和免疫细胞白细胞(WBC)、中性粒细胞(NEUT)、淋巴细胞(LY)的变化。结果观察组治疗1周后的血清slCAM-1为181.62±26.51ng/mL、IL-8为112.04±12.38pg/mL及TNF-α为51.72±3.25pg/mL,与对照组血清炎性指标值比较有明显下降;观察组治疗1周后免疫功能指标WBC为9.02±2.15×10~9/L、NEUT为6.04±2.46×10~9/L、LY为1.78±0.35×10~9/L明显低于对照组,以上数据两组比较差异均有统计学意义(P<0.05)。结论腹腔镜手术治疗小儿急性化脓感染的阑尾炎,对患儿的血清slCAM-1、IL-8以及TNF-α指标水平有显著改善,并且对患者相关的免疫功能有积极影响,是一种对阑尾炎急性化脓感染治疗的高效、理想的术式方法。OBJECTIVE To study the changes of levels of serum soluble intercellular adhesion molecule 1（slCAM-1）,interleukin-8（IL-8）,and tumor necrosis factor-α（TNF-α）in children with acute suppurative appendicitis who received laparoscopy and observe the impact on immune function.METHODS A total of 213 children with acute suppurative appendicitis who were treated in the hospital from Feb 2014 to Aug 2016 were enrolled in the study and divided into two groups.106 patients in the control group were treated with traditional open surgery,and 107 patients in the observation group were given laparoscopy.The levels of serum inflammatory factors slCAM-1,IL-8,and TNF-αas well as the immune cells white blood cell（WBC）,neutrophil（NEUT）,and lymphocyte（LY）were compared between the two groups of children before the treatment and after the treatment for 1 week.RESULTS The levels of serum slCAM-1,IL-8,and TNF-αof the observation group were respectively 181.62±26.51ng/mL,112.04±12.38pg/mL,and 51.72±3.25pg/mL after the treatment for 1week,as compared with the control group,they were remarkably reduced.The levels of immune function indexes WBC,NEUT,and LY of the observation group were respectively 9.02±2.15×10^9/L,6.04±2.46×10^9/L,and 1.78±0.35×10^9/L after the treatment for 1week,significantly lower than those of the control group（P〈0.05）.CONCLUSIONS The laparoscopy can remarkably improve the levels of serum slCAM-1,IL-8,and TNF-αof the children with acute suppurative appendicitis and has positive effect on the related immune function,it is an ideal,efficient surgical procedure for treatment of acute suppurative appendicitis.

关 键 词：腹腔镜 阑尾炎 急性化脓感染 slCAM-1 IL-8 TNF-Α 免疫功能 

分 类 号：R656.8[医药卫生—外科学]