腹腔穿刺引流对胰腺炎患者胰蛋白酶原激活肽、白介素-6表达的影响

摘要 目的：探讨腹腔穿刺引流对胰腺炎患者胰蛋白酶原激活肽(Trypsinogen activating peptide，TAP)、白介素-6(Interleukin-6，IL-6)表达的影响。方法：2017年8月至2019年12月选择在本院诊治的胰腺炎患者64例作为研究对象，根据随机数字表法把患者分为引流组与对照组各32例。对照组给予开腹引流手术治疗，引流组给予超声引导下腹腔穿刺引流治疗，记录不同时间点血清TAP、IL-6表达变化情况。结果：治疗后引流组的总有效率为100.0 %，显著高于对照组的87.5 %(P<0.05)。引流组的术后住院时间与术中出血量显著少于对照组(P<0.05)，两组手术时间对比无统计学意义(P>0.05)。引流组术后14 d的消化道瘘、腹腔出血、感染、胆漏等并发症发生率为6.3 %，显著低于对照组的25.0 %(P<0.05)。两组术后14 d的血清TAP、IL-6值低于术前1 d，引流组低于对照组，对比差异都有统计学意义(P<0.05)。结论：腹腔穿刺引流治疗胰腺炎患者有利于抑制TAP、IL-6的释放，并不会增加手术难度，且能减少对患者的创伤，降低并发症的发生，从而提高总体治疗效果。

Effect of Abdominal Puncture and Drainage on Expression of Trypsinogen-activating Peptide and Interleukin-6 in Patients with Pancreatitis

ABSTRACT Objective: To investigate the effect of peritoneal drainage on the expression of trypsinogen activating peptide (TAP) and interleukin-6 (IL-6) in patients with pancreatitis. Methods: From August 2017 to December 2019, 64 cases of patients with pancreatitis diagnosed and treated in our hospital were selected as the research object, and the patients were divided into drainage group and control group of 32 patients in each groups accorded to the random number table method. The control group were given open-drainage surgery, and the drainage group were given ultrasound-guided abdominal puncture and drainage treatment, and the changes of serum TAP and IL-6 expression at different time points were recorded. Results: The total effective rates of the drainage group after treatment were 100.0%, which were significantly higher than 87.5% of the control group (P<0.05). The postoperative hospital stay and the amount of bleeding in the drainage group were significantly less than those in the control group (P<0.05), and there were no statistically significant difference in the operation time compared between the two groups (P>0.05). The incidence of complications such as gastrointestinal fistula, abdominal hemorrhage, infection, and bile leakage in the drainage group at 14 days after operation were 6.3 %, significantly lower than that in the control group (25.0 %)(P<0.05). The serum TAP and IL-6 values at 14 days after operation in the two groups were lower than 1 day before operation, and the drainage group were lower than the control group, and compared the difference were statistically significant (P<0.05). Conclusion: Peritoneal drainage treatment of pancreatitis patients is beneficial to inhibit the release of TAP and IL-6, it does not increase the difficulty of surgery, and can reduce the trauma to patients and reduce the occurrence of complications, thereby improve the overall treatment effect.