Comparison of the efficacy, safety and cellular immune function of four surgical methods in the treatment of biliary severe acute pancreatitis

doi:10.3877/cma.j.issn.1674-3946.2018.05.022

Abstract

Abstract:

Objective

To investigate the efficacy, safety and cellular immune function of four surgical methods in the treatment of biliary severe acute pancreatitis.

Methods

60 patients with severe acute pancreatitis were divided into laparotomy group, laparoscope group, duodenoscopy group, laparoscopy combined with duodenoscopy group (combined group) according to the surgical treatment indication, with 15 cases in each group. The corresponding surgical treatment were perforemed and we compared the differences of efficacy, safety and cellular immune function among each group. The SPSS23.0 statistical software was used in this study. The cell immune function in each group was compared by F test. The treatment efficiency and the complications incidence were compared by the chi square test, and the difference of P<0.05 was statistically significant.

Results

The combined group is of the highest effective rate and CD3⁺ 、CD4⁺ , Treg cells numbers, while the lowest complications incidence and CD8⁺ T and Th17 cells number than other three groups, the differences were statistically significant (P<0.05).

Conclusion

Laparoscopy combined with duodenoscopy in the treatment of biliary severe acute pancreatitis has the best treatment efficacy and safety, and can improve the cellular immune function of patients.

Key words: Pancreatitis, Acute Necrotizing, Treatment Outcome, Safety, Immunity, Cellular, Comparative Study

Qingshen Wu, Gang Zhao, Yuanzhong Mu, Guoquan Jin. Comparison of the efficacy, safety and cellular immune function of four surgical methods in the treatment of biliary severe acute pancreatitis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(05): 428-430.

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References 17

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组别	例数	性别(男/女)	年龄(岁)	发病到手术时间(h)
开腹组	50	29/21	65.3±11.2	13.9±3.2
腹腔镜组	50	30/20	64.7±13.1	13.5±3.3
十二指肠镜组	50	31/19	63.9±12.8	13.1±3.5
联合组	50	31/19	66.7±12.3	13.6±3.4
P值	?	P>0.05	P>0.05	P>0.05
组别	例数	结石直径(cm)	胰腺CTSI^a	血淀粉酶(u/L)
开腹组	50	0.9±0.2	8.3±0.8	1103.2±30.8
腹腔镜组	50	0.9±0.3	8.4±0.9	1108.4±30.2
十二指肠镜组	50	0.9±0.2	8.7±0.9	1102.7±30.5
联合组	50	0.9±0.3	8.2±0.7	1105.3±29.7
P值	?	P>0.05	P>0.05	P>0.05

组别	例数	性别(男/女)	年龄(岁)	发病到手术时间(h)
开腹组	50	29/21	65.3±11.2	13.9±3.2
腹腔镜组	50	30/20	64.7±13.1	13.5±3.3
十二指肠镜组	50	31/19	63.9±12.8	13.1±3.5
联合组	50	31/19	66.7±12.3	13.6±3.4
P值	?	P>0.05	P>0.05	P>0.05
组别	例数	结石直径(cm)	胰腺CTSI^a	血淀粉酶(u/L)
开腹组	50	0.9±0.2	8.3±0.8	1103.2±30.8
腹腔镜组	50	0.9±0.3	8.4±0.9	1108.4±30.2
十二指肠镜组	50	0.9±0.2	8.7±0.9	1102.7±30.5
联合组	50	0.9±0.3	8.2±0.7	1105.3±29.7
P值	?	P>0.05	P>0.05	P>0.05

组别	例数	显效	缓解	无效	总有效率(%)
开腹组	50	23	17	10	40(80)^a
腹腔镜组	50	25	19	6	44(88)^a
十二指肠镜组	50	24	18	8	42(84)^a
联合组	50	29	20	1	49(98)

组别	例数	显效	缓解	无效	总有效率(%)
开腹组	50	23	17	10	40(80)^a
腹腔镜组	50	25	19	6	44(88)^a
十二指肠镜组	50	24	18	8	42(84)^a
联合组	50	29	20	1	49(98)

细胞因子	?	开腹组	腹腔镜组	十二指肠镜组	联合组
CD3^＋	治疗前	53.2±5.8	53.3±5.9	53.1±5.8	53.8±5.7
?	治疗后	62.6±4.8	69.2±4.0	69.6±4.8	75.4±2.9^a
CD4^＋	治疗前	28.1±4.6	28.1±4.7	28.6±4.7	28.7±4.3
?	治疗后	30.2±5.3	33.2±5.7	32.9±5.6	37.9±4.8^a
CD8^＋	治疗前	6.4±1.2	6.3±1.3	6.5±1.3	6.2±1.2
?	治疗后	3.8±0.7	2.5±0.6	2.6±0.7	1.6±0.4^a
Treg	治疗前	3.2±0.5	3.3±0.4	3.3±0.6	3.2±0.7
?	治疗后	6.6±1.3	7.7±1.2	7.9±1.2	9.6±1.5^a
Th17	治疗前	2.2±0.7	2.3±0.7	2.4±0.6	2.4±0.9
?	治疗后	1.82±0.4	1.5±0.3	1.5±0.4	1.0±0.3^a

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