论文部分内容阅读
目的:探讨腹腔镜下置管腹腔灌洗引流(LPLD)对重症急性胰腺炎(SAP)全身炎症反应的影响。方法:37例SAP患者按入院先后顺序随机分为内科组和LPLD组。检测并比较两组治疗前后0、1、3、7、10d外周血内毒素、TNF-α、IL-lβ、IL-6的浓度及单核细胞NF-κB的活性。结果:第0天LPLD组内毒素、TNF-α、IL-lβ、IL-6浓度及单核细胞NF-κB活性与内科组比较无显著差异;术后第10天,LPLD组内毒素、TNF-α、IL-lβ、IL-6浓度及单核细胞NF-κB活性分别为(1.64±0.13)pg/mL、(114.13±15.12)pg/mL、(80.17±18.06)pg/mL、(56.43±12.24)pg/mL、(68.2±1.7)%。上述指标与内科组比较均有显著下降(P<0.01orP<0.05)。结论:LPLD能明显减轻内毒素血症,减低NF-κB活性及细胞因子浓度,有效地减轻SAP患者的炎症反应。
Objective: To investigate the effect of laparoscopic peritoneal lavage and drainage (LPLD) on the systemic inflammatory response in severe acute pancreatitis (SAP). Methods: 37 patients with SAP were randomly divided into internal medicine group and LPLD group according to the order of admission. The concentrations of endotoxin, TNF-α, IL-1β and IL-6 in peripheral blood and the activity of NF-κB in monocytes were detected and compared at 0, 1, 3, 7 and 10 days before and after treatment. Results: The levels of endotoxin, TNF-α, IL-1β, IL-6 and NF-κB in LPLD group on day 0 were not significantly different from those in medical group. On the 10th day after operation, the levels of endotoxin, TNF (1.64 ± 0.13) pg / mL, (114.13 ± 15.12) pg / mL, (80.17 ± 18.06) pg / mL) and (56.43 ± 12.24) pg / mL, (68.2 ± 1.7)%. The above indicators were significantly decreased compared with the medical group (P <0.01orP <0.05). Conclusion: LPLD can significantly reduce endotoxemia, reduce NF-κB activity and cytokine concentration, and effectively reduce the inflammatory response in patients with SAP.