早期手术对重症胆源性梗阻型胰腺炎的疗效及其对患者血清MIP-1α、MIP-1β和MCP-1的影响  

Clinical efficacy of early operation for severe biliary obstructive pancreatitis and its effects on patients' serum MIP-1-Alpha,MIP-1-Beta and MCP-1

作　　者：逯青[1] 木努热丁.艾则孜 Lu qing;Mu Lu Re Ding · Ai Zezi(The first department of general surgery.The first people＇ s Hospital of Akesu,Urumqi,Xinjiang,84300)

机构地区：[1]阿克苏地区第一人民医院普外一科,新疆乌鲁木齐843000

出　　处：《中华普外科手术学杂志（电子版）》2018年第4期289-291,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：新疆维吾尔自治区科攻关计划项目(编号:201600452204)~~

摘　　要：目的探讨早期手术对重症胆源性梗阻型胰腺炎的疗效及对患者血清巨噬细胞炎性蛋白-1α(MIP-1α)、巨噬细胞炎性蛋白-1β(MIP-1β)以及单核细胞趋化因子蛋白1(MCP-1)的影响。方法总结2014年8月至2017年8月96例重症胆源性梗阻型胰腺炎患者资料,按照随机数字表法分为延期手术组(发病至手术时间>12 h),早期手术组(发病至手术时间≤12 h)进行治疗,各为48例。采用SPSS20.0软件对数据进行统计分析,两组手术效果及手术前、后血清中免疫指标均以(x±s)的形式表示,独立t检验;两组术后并发症发生率采用χ2检验;P<0.05表示差异有统计学意义。结果早期手术组患者住院时间、术后引流量及术后并发症发生率均分别显著小于延期手术组(P均<0.05);与术前相比,两组患者术后血清MIP-1α、MIP-1β和MCP-1水平均显著下降(P均<0.05),且早期手术组上述3个指标水平下降幅度大于延期手术组(P均<0.05)。结论早期手术对重症胆源性梗阻型胰腺炎的疗效显著。可有效降低患者血清MIP-1α、MIP-1β和MCP-1水平,可在临床中进行推广。Objective To explore the clinical efficacy of early operation for severe biliary obstructive pancreatitis and its effects on patients＇ serum macrophage inflammatory protein-1 alpha （MIP-1-Alpha） , macrophage inflammatory protein-1 beta （MIP-1 beta） and monocyte chemotactie factor protein 1 （ MCP 1 ）. Methods Clincal data of 96 patients with severe biliary obstructive pancreatitis from August 2014 to August 2017 were analyzed retrospectively. By using random digital table, the patients were divided into the delayed operation group （n = 48, the onset to operation 〉 12 h）, and the early operation group （the onset to operation less than 12 h） . The SPSS20. 0 software was used for data analysis. Perioperative measurement data and serum index were expressed as （ x± s）, and were examined by using t test. The postoperative complication rate and satisfaction rate were analyzed by Chi-square test. A P value 〈 0.05 was considered as statistically significant difference. Results The hospital stay, postoperative drainage and postoperative complications in the early surgical group were significantly lower than those in delayed operation group （P 〈 0. 05 ）. Compared with the preoperative data, postoperative serum MIP-1 alpha, beta and MIP-1 MCP-1 levels were significantly decreased in both two groups （P 〈 O. 05 ）. Compared with delayed operation group, peroperative changes of serum levels in early surgical group were significantly increased （P 〈 0.05）. Conclusion Early operation has significant effect on severe biliary obstruction type pancreatitis. The serum mip-1, mip-1 and McP-1 levels could be significantly reduced, andshould be promoted in clinical practice.

关 键 词：胰腺炎 外科手术 巨噬细胞炎性蛋白质类 单核细胞化学吸引蛋白质类 

分 类 号：R657.51[医药卫生—外科学]