急性胆囊炎患者应用胆囊穿刺引流对炎症因子和应激反应的影响  

Effects of Gallbladder Puncture and Drainage on Inflammatory Factors and Stress Response in Acute Cholecystitis

作　　者：周涛 石秀全[2] ZHOU Tao;SHI Xiuquan(Department of Clinical Laboratory,People’s Hospital of Yingshang,Yingshang 236200,China;The Third Department of General Surgery,People’s Hospital of Yingshang,Yingshang 236200,China)

机构地区：[1]安徽省颍上县人民医院检验科,安徽颍上236200 [2]安徽省颍上县人民医院普外三科,安徽颍上236200

出　　处：《标记免疫分析与临床》2022年第4期647-651,共5页Labeled Immunoassays and Clinical Medicine

基　　金：安徽省中医药传承创新科研项目基金(编号:2020ccyb29)。

摘　　要：目的探讨急性胆囊炎患者应用胆囊穿刺引流对炎症因子和应激反应的影响。方法随机选择在本院因急性胆囊炎就诊并收治入院的患者62例,分为观察组和对照组各31例,其中对照组患者术中开展常规胆囊造瘘术,观察组患者均接受胆囊穿刺引流术。比较两组患者围手术期的胆囊炎症状缓解情况、住院时间、并发症持续时间、二次手术情况;比较两组患者术前1 d和术后1、3、7 d的炎症因子IL-2、IL-4、IL-6、hs-CRP、TNF-α的水平变化情况,比较两组患者术前1 d和术后1、3、7 d的应激反应指标ACTH、Cor和GLU水平变化情况。结果两组患者围手术期的胆囊炎症状均得到了显著缓解,缓解率均为100.00%;且均未出现二次手术。但观察组患者的住院时间、并发症持续时间均较对照组明显减少和缩短。两组IL-2、IL-4、IL-6、hs-CRP、TNF-α等炎症因子指标水平存在时间、组间、时点与组别的交互效应(P均<0.05)。术前1 d,两组IL-2、IL-4、IL-6、hs-CRP、TNF-α比较,差异无统计学意义(P均>0.05)。和术前相比,术后观察组IL-2降低,IL-4、IL-6、hs-CRP、TNF-α均增高,但均低于对照组,差异有统计学意义(P均<0.05)。两组ACTH、Cor和GLU存在时间、组间、时点与组别的交互效应(P均<0.05)。术前1d,两组ACTH、Cor和GLU比较,差异无统计学意义(P均>0.05)。和术前相比,术后观察组ACTH、Cor和GLU均增高,但均低于对照组,差异有统计学意义(P均<0.05)。结论急性胆囊炎患者接受胆囊穿刺引流治疗,与常规胆囊造瘘术相比,不仅能够显著减轻患者机体炎症因子水平,减轻炎症反应;而且能够显著减轻患者的机体应激反应。Objective To investigate the effect of gallbladder puncture and drainage on inflammatory factors and stress response in acute cholecystitis patients.Methods A total of 62 patients with acute cholecystitis cholecystectomy who were admitted to our hospital were randomly divided into the observation group and control group(n=31).Control group patients had regular gallbladder fistula operation,while in the observation group,all patients accept the gallbladder puncture drainage.Perioperative cholecystitis symptom relief,length of hospital stay,duration of complications and secondary operation were compared between the two groups.The levels of inflammatory factors IL-2,IL-4,IL-6,hs-CRP and TNF-αwere compared between the two groups 1d before surgery and 1d,3d and 7d after surgery,and the levels of stress response indicators ACTH,Cor and GLU were compared between the two groups 1d before surgery and 1d,3d and 7d after surgery.Results The symptoms of perioperative cholecystitis in both groups were significantly relieved,and the remission rate was 100.00%.There were no secondary operations.However,hospital stay and duration of complications in the observation group were significantly reduced and shortened compared with the control group.The levels of Il-2,IL-4,IL-6,hs-CRP,TNF-αand other inflammatory factors in both groups had interaction effects of time,intergroup,time point and group(all P<0.05).1d before surgery,there were no significant differences in IL-2,IL-4,IL-6,hs-CRP and TNF-αbetween the two groups(all P>0.05).On 1d,3d and 7d after surgery,IL-2 in the observation group was decreased,while IL-4,IL-6,hs-CRP and TNF-αwere all increased,which were lower than those in the control group(P<0.05).The interaction effects of ACTH,Cor and GLU in the two groups were observed in time,between groups,time point and group(P<0.05).1d before surgery,there were no significant differences in ACTH,Cor and GLU between the two groups(all P>0.05).On 1d,3d and 7d after surgery,ACTH,Cor and GLU in the observation group were all higher

关 键 词：急性胆囊炎 胆囊穿刺引流 炎症因子 应激反应 

分 类 号：R575.61[医药卫生—消化系统]