腹腔镜与开腹腹膜透析置管术对机体炎症反应影响的临床研究  

Clinical study on the effect of laparoscopic and open peritoneal dialysis catheterization on inflammatory response

作　　者：郑婕[1] 李小生[1] 彭凤[1] 叶菁[2] ZHENG Jie;LI Xiaosheng;PENG Feng;YE Jing(The First Affiliated Hospital of Gannan Medical University,Ganzhou341000,China;Jiangxi University of Traditional Chinese Medicine,Nanchang330004,China)

机构地区：[1]赣南医学院第一附属医院,江西赣州341000 [2]江西中医药大学,江西南昌330004

出　　处：《中国现代医生》2021年第11期17-20,共4页China Modern Doctor

基　　金：江西省赣州市指导性科技计划任务项目(GZ2018 ZSF044)。

摘　　要：目的探讨腹腔镜与开腹腹膜透析置管术对机体炎症反应的影响。方法选取2018年10月至2019年1月于我院行腹膜透析的60例尿毒症患者,其中30例行腹腔镜下腹膜透析置管手术的设为腹腔镜组,30例行开腹腹膜透析置管手术的设为开腹组。比较两组术中、术后情况和机体炎症反应、并发症发生情况。结果腹腔镜组术中出血量、疼痛程度、术后3 d降钙素原(PCT)、C反应蛋白(CRP)、癌抗原125(CA125)、白细胞(WBC)计数和引流不畅、导管移位、腹膜炎发生率低于开腹组,肠道功能恢复时间长于开腹组,手术时间短于开腹组,差异有统计学意义(P<0.05);两组住院时间比较,差异无统计学意义(P>0.05)。结论尿毒症患者行腹腔镜腹膜透析置管术具有创伤小、失血量少、疼痛轻微、炎症反应轻、并发症少等优点,值得临床推广。Objective To explore the influence of laparoscopic and open peritoneal dialysis catheterization on inflammation.Methods Sixty uremic patients who underwent peritoneal dialysis in our hospital from October 2018 to January 2019 were selected.30 cases of laparoscopic peritoneal dialysis catheter were set as the laparoscopic group,and 30 cases of open peritoneal dialysis catheter were set as the laparotomy group.The intraoperative and postoperative conditions,inflammatory reaction and complications of the two groups were compared.Results The bleeding volume,pain degree,procalcitonin(PCT),C-reactive protein(CRP),cancer antigen 125(CA125),white blood cell(WBC)count and poor drainage,catheter displacement and peritonitis in laparoscopic group were lower than those in laparotomy group.The recovery time of intestinal function was longer,and the operation time was shorter than that of laparotomy group,with statistically significant difference(P<0.05).There was no significant difference in hospital stay between the two groups(P>0.05).Conclusion Laparoscopic peritoneal dialysis catheterization has the advantages of less trauma,less blood loss,less pain,less inflammatory reaction and fewer complications for uremic patients,which is worthy of clinical promotion.

关 键 词：尿毒症 腹膜透析置管术 腹腔镜 炎症反应 疼痛程度 并发症 

分 类 号：R735.2[医药卫生—肿瘤]