摘要
目的观察比较内镜介入和开腹治疗急性化脓性胆管炎的临床疗效及对血清高迁移率族蛋白B1(HMGBl)、可溶性髓样细胞触发受体-1(s TREM-1)和高敏C反应蛋白(hs-CRP)的影响。方法按照手术方式不同将82例急性化脓性胆管炎患者分为2组,观察组47例予以内镜介入治疗,对照组35例予以开腹手术治疗。观察2组休克纠正、腹痛缓解、下床活动、胃肠功能恢复及住院时间和并发症发生率,检测2组治疗前和治疗后3 d白细胞计数(WBC)、丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、HMGB1、s TREM-1和hs-CRP水平。结果观察组休克纠正、腹痛缓解、下床活动、胃肠功能恢复和住院时间均明显短于对照组(P均<0.05),并发症发生率明显低于对照组(P<0.05)。2组治疗前WBC、ALT、TBil、HMGB1、s TREM-1和hs-CRP水平比较差异均无统计学意义(P均>0.05),2组治疗后各指标水平均较治疗前明显降低(P均<0.05),且观察组各指标水平明显低于对照组(P均<0.05)。结论内镜介入治疗急性化脓性胆管炎具有创伤小、恢复快、黄疸消退快等优点,且可明显减轻机体的炎症反应。
Objective It is to investigate the efficacy of endoscopic therapy and open surgery in treatment of acute suppurative cholangitis, and their impact on high mobility group box - 1 protein （HMGB1） , soluble triggering receptor expressed on myloid cells - 1 （ sTREM - 1） and high-sensitive C - reactive protein （ hs - CRP）. Methods 82 patients with acute suppurative cholangitis were divided into observation group （47 cases） and control group （35 cases） according to different modus operandi, observation group were performed with endoscopic therapy,and control group were gaved laparotomy. Shock recovery, abdominal pain,out-of-bed activity, recovery of gastrointestinal function and hospital stay and complication rates were observed in each group, as well as the levels of white blood cell （WBC） , alanine aminotransferase （ALT）, total bilirubin （TBil） , HMGB1, sTREM - 1 and hs - CRP were detected in two groups before and after treatment. Results The shock recovery, abdominal pain, out-of-bed activity, recovery of gastrointestinal function and hospital stay and complication rates were significantly shorter or lower than those in control group （P 〈 0. 05）. Before treatment, the levels of WBC, ALT, TBil, HMGB1, sTREM - 1 and hs - CRP were not statistically significant different （P 〉 0.05） , after treatment, the levels of those were significantly lower compared with those before treatment （P 〈 0. 05） , while the decrease of the observation group were more significant（P 〈 0.05）. Conclusion The efficacy of endoscopic therapy in treatment of acute suppurative cholangitis is obvious, with less trauma, fast jaundice regression, it can reduce the body＇s inflammatory response.
出处
《现代中西医结合杂志》
CAS
2016年第4期357-359,364,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
内镜介入
手术
炎症
急性化脓性胆管炎
高迁移率族蛋白B1
髓样细胞触发性受体-1
endoscopic intervention
surgery
inflammation
acute suppurative cholangitis
high mobility group box - 1 protein
soluble triggering receptor expressed on myloid cells - 1
作者简介
张毅，男，主治医师，从事肝胆外科疾病的研究。
[通信作者]沈锋，E-mail：shenfengehbh@sina．com
