胆道镜对急性重症胰腺炎腹腔脓肿患者血清TNF-α、IL-6、IL-8及CRP因子水平的影响  

Effects of Choledochoscopy on Serum TNF-α,IL-6,IL-8 and CRP Factor Levels in Patients with Acute Severe Peritoneal Abscess of Pancreatitis

作　　者：李婧伊[1] 刘飞[1] 祁春春 史力军[1] 马跃峰[1] LI Jingyi;LIU Fei;QI Chunchun;SHI Lijun;MA Yuefeng

机构地区：[1]大连大学附属中山医院,辽宁大连116001

出　　处：《中国医学创新》2020年第1期9-12,共4页Medical Innovation of China

摘　　要：目的:探讨胆道镜对急性重症胰腺炎腹腔脓肿患者血清TNF-α、IL-6、IL-8及CRP因子水平的影响。方法:选择2011年1月-2018年12月本院收治的急性重症胰腺炎腹腔脓肿患者65例,根据治疗方法不同分为对照组28例和胆道镜组37例。对照组给予传统开腹引流治疗,胆道镜组给予胆道镜引流治疗。比较两组患者临床疗效、围手术期指标、并发症发生情况及血清炎性因子水平变化情况。结果:胆道镜组总有效率为97.3%,明显高于对照组的60.7%,差异有统计学意义(P<0.05);胆道镜组术中出血量、住院时间均少于对照组,差异均有统计学意义(P<0.05);胆道镜组并发症总发生率为5.4%,明显低于对照组的42.9%,差异有统计学意义(P<0.05);术后,两组患者各项炎性因子水平均低于术前,且胆道镜组均明显低于对照组,差异均有统计学意义(P<0.05)。结论:急性重症胰腺炎腹腔脓肿患者使用胆道镜治疗,与传统开腹手术相比,胆道镜临床效果更佳,患者住院时间有明显缩短,发生并发症的人数显著减少,炎性反应进一步降低,加速患者体征、症状恢复,胆道镜具有较高的应用价值。Objective:To investigate the effect of choledochoscopy on serum levels of TNF-α,IL-6,IL-8 and CRP in patients with abdominal abscess of acute severe pancreatitis.Method:A total of 65 patients with abdominal abscess of acute severe pancreatitis admitted to our hospital from January 2011 to December 2018 were selected.According to different treatment methods,the patients were divided into control group(n=28)and choledochoscopy group(n=37).The control group was treated with traditional laparotomy drainage,and the choledochoscopy group was treated with choledochoscopy drainage.The clinical efficacy,perioperative indicators,complications and serum inflammatory factors were compared between the two groups.Result:The total effective rate of the choledochoscopy group was 97.3%,significantly higher than 60.7%of the control group,the difference was statistically significant(P<0.05).The intraoperative blood loss and hospital stay in the choledochoscopy group were less than those in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the choledochoscopy group was 5.4%,significantly lower than 42.9%in the control group,and the difference was statistically significant(P<0.05).After surgery,the levels of inflammatory factors in both groups were lower than before surgery,and the levels in the choledochoscopy group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Patients with with abdominal abscess of acute severe pancreatitis are treated with choledochoscopy,compared with traditional open surgery,choledochoscopy is more effective clinically.The length of hospital stay has been significantly reduced,the number of complications has been significantly reduced,the inflammatory response goes down even further.Accelerate the recovery of signs and symptoms,choledochoscopy has high application value.

关 键 词：超声引导下穿刺置引流管 胆道镜微创治疗术 急性重症胰腺炎 腹腔脓肿 并发症 血清炎性因子 

分 类 号：R576[医药卫生—消化系统]