| 秦禄武,何龙海.三镜联合术联合静脉注射舒肝宁治疗梗阻性化脓性胆管炎46例[J].安徽医药,2016,20(9):1763-1766. |
| 三镜联合术联合静脉注射舒肝宁治疗梗阻性化脓性胆管炎46例 |
| Efficacy of three mirror combination operation in combination with Shuganning Injection in treating obstructive suppurative cholangitis |
| 投稿时间：2016-03-23 |
| DOI： |
| 中文关键词: 胆管炎 十二指肠镜检查 腹腔镜检查 内窥镜检查,消化系统 利胆药和促胆汁分泌药 茵陈 |
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| 中文摘要: |
| 目的 探讨三镜联合术联合舒肝宁注射液治疗梗阻性化脓性胆管炎的疗效及对血清和胆汁中肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6 和IL-10水平的影响。方法 收集92例急性梗阻性化脓性胆管炎患者,根据随机数字表法分为治疗组(46例)和对照组(46例)；所有患者给予禁饮食等常规干预；对照组应用十二指肠镜、腹腔镜、胆道镜行胆囊切除及胆道探查术；治疗组:在对照组基础上于术后1 d应用舒肝宁注射液治疗,1次/d,连续治疗1周。比较两组直接胆红素(DBIL)、谷丙转氨酶(ALT)及胆碱酯酶(CHE)水平；对所有患者随访12个月,比较两组并发症发生率；检测两组血清和胆汁中TNF-α、IL-6 和IL-10水平。结果 治疗组血清DBIL和ALT水平明显低于对照组,CHE明显高于对照组(P＜0.01)；随访1年后,治疗组患者未见结石残留等并发症,对照组患者并发症发生率为13.04%,两组比较差异有统计学意义(P＜0.05)；术后5 d,治疗组患者血清和胆汁中TNF-α和IL-6水平均明显低于对照组,IL-10水平明显高于对照组(P＜0.01)。结论 三镜联合术联合舒肝宁注射液治疗梗阻性化脓性胆管炎的疗效明显,且可降低并发症发生率,抑制血清和胆汁中TNF-α和IL-6 水平及上调IL-10水平可能与上述疗效有关。 |
| 英文摘要: |
| Objective To investigate the efficacy of three mirror combination operation in combination with Shuganning Injection in treating obstructive suppurative cholangitis and its influence on serum and bile levels of tumor necrosis factor(TNF)-α,interleukin(IL)-6,and IL-10.Methods Ninety-two patients with acute obstructive suppurative cholangitis were randomized into control group(n=46) and observation group(n=46) by random number table.All cases were given fasting treatment.The control group underwent cholecystectomy with duodenoscopy,laparoscopy,choledochoscopy and bile duct exploration.In addition to the above-mentioned treatment,the treatment group was given an additional Shuganning Injection after 1 d,1 time/d and for 1 week.Levels of DBIL,ALT,and CHE were compared between the two groups.All cases were followed up for 12 months,and complication rate was compared between both groups.Serum and bile levels of TNF-α,IL-6,and IL-10 were detected in both groups.Results After treatment,serum levels of DBIL and ALT in the observation group were significantly lower,while CHE was significantly higher than the control group(P＜0.01).After 1-year follow-up,complication was not found in the observation group,while the complication incidence rate was 13.04% in the control group with statistical significance(P＜0.05).Five days after operation,serum and bile levels of TNF-α and IL-6 in the observation group were significantly lower,while IL-10 was significantly higher than in the control group(P＜0.01).Conclusions Efficacy of three mirror combination operation in combination with Shuganning Injection in treating obstructive suppurative cholangitis achieves a significant effect,and down-regulation of TNF-αand IL-6 and up-regulation of IL-10 in serum and bile levels may be relevant to its effect. |
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