摘要
目的探讨CO2气腹对急性腹腔炎症患者术后免疫应激反应的影响。方法将40例急性阑尾炎患者按入院的先后顺序分为试验组和对照组,每组20例。试验组患者采用腹腔镜下阑尾切除术,对照组患者采用开腹阑尾切除术。观察2组患者术前2h,术后第1、3、5天白细胞计数、中性粒细胞计数和血清肿瘤坏死因子-α、白细胞介素-10水平的变化。结果与同组术前2h比较,对照组患者术后第3天血清肿瘤坏死因子-α、白细胞介素-10水平均明显升高(均P<0.05);2组患者术后第1天血白细胞计数、中性粒细胞计数及血清肿瘤坏死因子-α、白细胞介素-10水平均显著升高,术后第5天血白细胞计数、中性粒细胞计数及血清肿瘤坏死因子-α、白细胞介素-10水平均明显降低(P<0.05或P<0.01)。与对照组比较,试验组患者术后第3、5天血白细胞计数、中性粒细胞计数及术后第1、3、5天血清肿瘤坏死因子-α、白细胞介素-10水平均明显降低(均P<0.05)。结论 CO2气腹能够明显减轻急性阑尾炎患者手术创伤引起的炎症反应和代偿性抗炎反应,减轻术后免疫应激反应程度,有利于患者机体免疫功能的保护。
Objective To investigate the effect of CO2 pneumoperitoneum on postoperative immune stress response in patients with acute appendicitis.Methods According to the order of admission,40 patients with acute appendicitis were randomly assigned to receive either laparoscopic appendectomy（experimental group,n=20）or open appendectomy（control group,n=20）.White blood cell count,neutrophil count and serum tumor necrosis factor-αand interleukin-10 levels were measured at 2hours before operation and on postoperative days 1,3and 5.Results Serum tumor necrosis factor-αand interleukin-10 levels measured on postoperative day 3 were higher than those measured at 2hours before operation in control group.Furthermore,white blood cell count,neutrophil count and serum tumor necrosis factor-αand interleukin-10 levels increased on postoperative day 1,but decreased on postoperative day 5in both groups（P〈0.05 or P〈0.01）.Moreover,white blood cell count and neutrophil count measured on postoperative days 3and 5and serum tumor necrosis factor-αand interleukin-10 levels measured on postoperative days 1,3and 5in experimental group were lower than those in control group（P〈0.05）.Conclusion CO2 pneumoperitoneum can reduce inflammatory response and compensatory anti-inflammatory response caused by surgical trauma,relieve postoperative immune stress response,and contribute to the protection of immune function in patients with acute appendicitis.
出处
《实用临床医学（江西）》
CAS
2016年第4期14-17,共4页
Practical Clinical Medicine
基金
江西省卫生厅科技支撑计划项目(20112054)
