摘要
目的：研究腹腔镜下肝叶切除术治疗肝内胆管结石的疗效及对血清学指标的影响。方法：选择2013年5月~2014年8月期间就诊的80例肝内胆管结石患者进行研究,接受肝叶切除术,随机分为接受腹腔镜下肝叶切除术的观察组以及接受开腹肝叶切除术的对照组,采集血清后检测炎症指标、应激指标、肝损伤分子、疼痛信号分子的含量。结果：（1）炎症应激反应程度：与对照组比较,观察组患者血清中核转录因子（NF-кB）、白细胞介素17（IL-17）、白细胞介素23（IL-23）、皮质醇（Cor）、去甲肾上腺素（NE）、肾上腺素（E）的含量较低（P〈0.05）;（2）肝损伤指标：与对照组比较,观察组患者血清中总胆汁酸（TB）、α-谷胱甘肽S转移酶（α-glutathione-S-transferase,α-GST）、嘌呤核苷磷酸化酶（purinenucleosidephosphorylase,PNP）、鸟氨酸氨基甲酰转移酶（ornithinecarbamyl transferase,OCT）、谷胱苷肽脱氢酶（Glutamic dehydrogenase,GLDH）、精氨酸酶I（Arginase I,Arg I）含量较低（P〈0.05）;（3）疼痛信号分子：与对照组比较,观察组患者血清中JAK2、STAT3、STAT5、c-Jun氨基末端激酶（C-Jun N-terminal kinase,JNK）、MCP-1的mRNA含量较低（P〈0.05）。结论：腹腔镜下肝叶切除术有助于减轻炎症应激反应、控制肝组织损伤、抑制疼痛信号通路激活,是治疗肝内胆管结石的理想手术方式。
Objective：To study the curative effect of laparoscopic liver resection in treating intrahepatic bile duct stone and its influence on serum indexes.Methods：A total of 80 cases of intrahepatic bile duct stone treated in our hospital from May2013 to August 2014 were enrolled.They received liver resection and were randomly divided into observation group who received laparoscopic liver resection and control group who received open liver resection.Then serum was collected to detect inflammatory indexes,stress indexes,liver injury molecule and pain signal molecule contents.Results：Compared with control group,serum NF-кB,IL-17,IL-23,Cor,NE and E contents of observation group were lower;serum TB,α-GST,PNP,OCT,GLDH and Arg I contents of observation group were lower than;serum mRNA contents of JAK2,STAT3,STAT5,JNK and MCP-1of observation group were lower.Conclusion：Llaparoscopic liver resection is helpful to reduce inflammatory stress response,control liver tissue injury and inhibit activation of pain signal pathway.It＇s an ideal surgical method in treating intrahepatic bile duct stone.
出处
《海南医学院学报》
CAS
2015年第9期1235-1237,1241,共4页
Journal of Hainan Medical University
基金
梅州市科技计划项目(2014B50)~~
关键词
肝内胆管结石
肝叶切除术
腹腔镜
炎症应激反应
肝损伤
信号通路
Intrahepatic bile duct Liver resection laparoscopy Inflammatory reaction Liver injury Signal pathway
