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河北医学  2020, Vol. 26 Issue (1): 33-36    DOI: 10.3969/j.issn.1006-6233.2020.01.008
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腔镜及开腹手术对阑尾穿孔腹膜炎脓毒症患儿免疫指标及细胞因子的影响
完玛南杰, 李成棽
青海红十字医院小儿外科, 青海 西宁 810000
Effects of Laparoscopy and Laparotomy on Immune Indexes and Cytokines in Children with Appendiceal Perforation Peritonitis and Sepsis
WAN Mananjie, LI Chengchen
Qinghai Red Cross Hospital, Qinghai Xining 810000, China
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摘要 目的:探讨腔镜及开腹手术对阑尾穿孔腹膜炎脓毒症患儿免疫指标及细胞因子的影响。方法:选择2017年3月至2018年6月间我院收治的64例阑尾穿孔腹膜炎脓毒症患儿作为研究对象,通过简单随机数字表法将所有研究对象分为观察组及对照组,每组32例。观察组患儿行腹腔镜手术,对照组患儿行传统开腹手术,比较两组患儿术前、术后1、3d的IgG、IgM、IL-6、IL-10水平变化及术后并发症发生情况。结果:术前,两组患儿的IgG、IgM、IL-6、IL-10水平比较,差异均无统计学意义(P均>0.05)。术后1d,两组患儿的IgG、IL-10水平均低于术前,而IL-6水平均高于术前,差异均具有统计学意义(P均<0.05);两组患儿的IgM水平与术前比较,差异均无统计学意义(P均>0.05)。术后3d,两组患儿的IgG、IL-6水平均低于术后1d,而IL-10水平均高于术后1d,差异均具有统计学意义(P均<0.05),IgM水平与术后1d比较,差异无统计学意义(P>0.05)。两组患儿的术后并发症比较,差异无统计学意义(P>0.05)。观察组患儿术后并发症发生率为6.25%,低于对照组患儿(25.00%),差异具有统计学意义(P<0.05)。结论:腹腔镜对阑尾穿孔腹膜炎脓毒症患儿的免疫指标及细胞因子水平的改善作用优于开腹手术,值得临床推广。
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完玛南杰
李成棽
关键词 腹腔镜开腹手术阑尾穿孔腹膜炎脓毒症免疫指标细胞因子    
AbstractObjective: To investigate the effects of laparoscopy and laparotomy on immune indexes and cytokines in children with appendiceal perforated peritonitis and sepsis. Methods: 64 children with appendicitis perforated peritonitis admitted to our hospital from March 2017 to June 2018 were enrolled. All subjects were divided into observation group and control group by simple random number table method, 32 cases in each group. Laparoscopic surgery was performed in the observation group, and traditional open surgery was performed in the control group. The changes of IgG, IgM, IL-6, IL-10 levels and postoperative complications were compared between the two groups before and after surgery. Results: Before operation, there was no significant difference in the levels of IgG, IgM, IL-6 and IL-10 between the two groups (P>0.05). On the 1st day after operation, the levels of IgG and IL-10 in the two groups were lower than those before operation, while the levels of IL-6 were higher than those before operation. The difference was statistically significant (P<0.05). There was no significant difference in the levels of IgM between the two groups before operation (P>0.05). On the 3rd day after operation, the levels of IgG and IL-6 in the two groups were lower than those of the 1st day after operation, while the levels of IL-10 were higher than those of the 1st day after operation. The difference was statistically significant (P<0.05). There was no significant difference between the levels of IgM and the 1st day after operation (P>0.05). There was no significant difference in postoperative complications between the two groups (P>0.05). The incidence of postoperative complications in the observation group was 6.25%, which was lower than that in the control group (25.00%), and the difference was statistically significant (P<0.05). Conclusions: Laparoscopy is superior to laparotomy in improving immune indexes and cytokine levels in children with appendical perforation peritonitis and sepsis, which is worthy of clinical promotion.
Key wordsLaparoscopy    Open surgery    Appendix perforation    Peritonitis    Sepsis    Immune indexes    Cytokines
    
基金资助:青海省自然科学基金项目,(编号:2018-F-658R)
引用本文:   
完玛南杰, 李成棽. 腔镜及开腹手术对阑尾穿孔腹膜炎脓毒症患儿免疫指标及细胞因子的影响[J]. 河北医学, 2020, 26(1): 33-36.
WAN Mananjie, LI Chengchen. Effects of Laparoscopy and Laparotomy on Immune Indexes and Cytokines in Children with Appendiceal Perforation Peritonitis and Sepsis. HeBei Med, 2020, 26(1): 33-36.
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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.01.008     或     http://www.hbyxzzs.cn/CN/Y2020/V26/I1/33
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