摘要
目的对比分析粘连性小肠梗阻手术与全身炎症反应综合征(SIRS)检测结果的相关性,为治疗粘连性小肠梗阻提供理论依据。方法回顾性分析2015年1月至2018年1月106例粘连性小肠梗阻患者,按治疗方式分为手术组58例,非手术组48例。采用SPSS 21. 0软件对数据作统计学分析,两组患者SIRS因子检测分析采用χ2检验;两组患者白细胞计数、非手术治疗天数、治疗前后细胞因子及内毒素表达水平以(x珋±s)表示,采取独立t检验; SIRS因子阳性参数与手术风险之间关系采用Logistic回归分析,以P <0. 05为差异有统计学意义。结果手术组患者白细胞计数和非手术治疗天数明显大于非手术组患者(P <0. 05);两组患者SIRS因子阳性参数项的数量与手术密切相关(P <0. 05),回归分析显示,SIRS因子阳性参数每增加1项,需要手术的风险增加2. 565倍;手术组患者SIRS检测阳性率明显高于非手术组患者(P <0. 05);回归分析显示,SIRS检测阳性需要手术的风险是SIRS检测阴性的3. 558倍。两组患者治疗后TNF-α、内毒素、IL-8、IL-6表达水平均降低,IL-2表达水平升高(P <0. 05),手术后两组患者组间比较5项指标差异均有统计学意义(P <0. 05)。结论 SIRS因子临床检测结果可作为粘连性小肠梗阻患者是否需要进行手术治疗的预测因子,为治疗粘连性小肠梗阻提供可靠依据。
Objective By comparing the correlation between the surgery for adhesive small intestinal obstruction and SIRS test results,to provide a theoretical basis for the treatment of adhesive small bowel obstruction. Methods A total of 106 patients with adhesive small bowel obstruction who were admitted to our hospital from January 2015 to January 2018 were selected as subjects.According to the treatment,58 cases were divided into surgical treatment group and 48 cases were divided into non-surgical treatment group.SPSS21.0 was used for statistical analysis.The positive SIRS factor of the two groups was compared withχ2 test.The patients’heart rate,body temperature,respiration,white blood cell count,tumor necrosis factor a(TNF-α),interleukin 2(IL-2),interleukin-6(IL-6),interleukin-8(IL-8)and endotoxin levels were recorded and compared with independent t test.P<0.05 was considered as significant difference. Results The number of white blood cell counts and days of non-surgical treatments in the surgical group was significantly higher than those in the non-surgical group(P<0.05).The number of positive parameters in SIRS factor of the two groups was closely related to surgery(P<0.05).Regression analysis showed that when the positive parameters in SIRS factor added one item,the risk of surgery added 2.565 times;the positive rate of SIRS factorin the surgery group was significantly higher than the non-surgical groups(P<0.05),regression analysis showed that the opportunities for surgery of positive of SIRS detection cases was 3.558 times than the negative cases;after treatment,the expression levels of TNF-α,LPS,IL-8,IL-6 were decreased,the expression levels of IL-2 was increased in both of the two groups.After surgery,the expression levels of TNF-α,IL-2,IL-6,IL-8 and endotoxin were significantly different(P<0.05). Conclusion The SIRS factor can be used as a predictor of whether the surgical treatment is needed for patients with adhesive small bowel obstruction.
作者
王骅
李文煜
Wang Hua;Li Wenyu(Gastrointestinal surgery,Huizhou No.1 people’s Hospital,516000)
出处
《中华普外科手术学杂志（电子版）》
2019年第1期61-64,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
2018惠州市科技计划(医疗卫生项目)(No.2018Y104)~~
关键词
肠梗阻
组织粘连
系统性炎症反应综合征
回归分析
Intestinal obstruction
Tissue adhesions
Systemic inflammatory response syndrome
Regression analysis
