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邱庆文.重症急性胰腺炎患者腹腔镜手术围术期胃肠激素及机体应激状态变化观察.[J].中南医学科学杂志.,2015,43(6):675-678.

重症急性胰腺炎患者腹腔镜手术围术期胃肠激素及机体应激状态变化观察

Changes of Gastrointestinal Hormone and Body Stress State during Laparoscopic Surgery in Severe Acute Pancreatitis Patients

投稿时间：2015-09-22

DOI：

中文关键词: 重症急性胰腺炎腹腔镜手术胃肠激素应激反应

英文关键词:severe acute pancreatitis laparoscopic surgery gastrointestinal hormone stress response

基金项目:

作者	单位
邱庆文	（琼海市人民医院普外科，海南　琼海　571400）

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中文摘要:

目的　探究重症急性胰腺炎（SAP）患者采用腹腔镜手术的治疗效果，并分析围手术期胃肠激素及机体应激状态变化水平。方法　选择腹腔镜手术重症急性胰腺炎患者78例，和同期开腹手术重症急性胰腺炎患者78例，对两组治疗效果进行比较，分析比较两组围手术期胃肠激素水平、应激状态水平、炎症水平变化情况。结果　腹腔镜组治疗的显效率、总有效率分别为52.56%（41/78）、94.87%（74/78），均显著高于开腹组的35.90%（28/78）、80.77%（63/78）；两组治疗前血浆胃动素、生长抑素、皮质醇、肾上腺素、白细胞介素6（IL-6）以及C反应蛋白（CRP）水平比较无差异。在治疗后胃动素、生长抑素均出现不同程度下降，但整体上腹腔镜组皮质醇、肾上腺素水平显著高于开腹组（P＜0.05）。而皮质醇、肾上腺素、IL-6以及CRP水平在治疗后均出现不同程度上升，但腹腔镜组相显著低于开腹组（均P＜0.05）。结论　采用腹腔镜手术对SAP患者进行治疗效果积极，对胃肠激素以及机体应激状态水平影响更小，并且手术前后炎症水平处于相对正常的状态，在临床上具有更广泛的应用范围。

英文摘要:

Objective To explore the therapeutic effect of laparoscopic surgery for severe acute pancreatitis （SAP） patients,and analyze the changes in the levels of gastrointestinal hormones and body stress during perioperative period. Methods From January 2012 to June 2014 in our hospital,78 cases of severe acute pancreatitis were admitted to the hospital,and the observation group was recorded.78 cases of severe acute pancreatitis treated by open surgery in our hospital were recorded as the control group,the therapeutic effect of the two groups,the level of gastrointestinal hormone,the level of stress and the level of inflammation in the perioperative period were compared. Results In the total effective rate of the observation group was 52.56% （41/78） and 94.87% （74/78）,respectively,which was significantly higher than that of the control group of 35.90% （28/78）,80.77% （63/78）.The two groups before treatment,plasma motilin,somatostatin,cortisol,epinephrine,IL-6 and CRP levels had no significant differences.After the treatment motilin and somatostatin were decreased in different degree respectively,but in the overall observation group,the serum cortisol and epinephrine levels were significantly higher than those in the control group.While the levels of cortisol,epinephrine,IL-6 and were increased after treatment,the levels of serum cortisol,adrenaline,adrenaline,adrenaline,adrenaline,adrenaline,adrenaline,adrenaline,adrenaline,and CRP were significantly lower than those in the control group.The difference was statistically significant （P<0.05）. Conclusion Laparoscopic surgery has positive effect on the treatment of patients with SAP,and has a smaller effect on the gastrointestinal hormone and the stress state of the body.And the level of inflammation is related to the normal state,and it has a wider range of applications.

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