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目的:探讨腹腔镜治疗小儿腹股沟斜疝手术前后对外周血白介素-1β(IL-1β)、免疫球蛋白A、G、M(IgA、IgG、IgM)的变化。方法:将50例腹股沟斜疝的患儿按抽签方式,分为腹腔镜组和开放组各25例。腹腔镜组行腹腔内环口疝囊结扎术;开放组行腹股沟部切开疝囊高位结扎。于手术前1天早晨空腹、术后即刻、手术后第2天早晨空腹采外周静脉血,用ELISA法测定血浆中的IL-1β、IgM、IgA、IgG的含量。结果:2组术后即刻IL-1β、IgM、IgA、IgG比手术前均有显著升高(腹腔镜组q=11.307、22.111、24.161、23.111、P<0.05;开放组q=16.668、21.707、23.707、22.707,P<0.05);但开放组上述指标明显高于腹腔镜组(t=-4.509、P=0.000;t=-4.745、P=0.000;t=5.745、P=0.000;t=-6.745、P=0.000)。术后第2天,与术前相比腹腔镜组IL-1β、IgM、IgA、IgG,差异无显著性(q=0.482、3.853、4.653、4.853,P>0.05);而开放组仍高于术前(q=10.599、11.379、10.768、12.379,P<0.05)。2组相比,开放组明显高于腹腔镜组(t=-5.051、P=0.000;t=-3.730、P=0.001;t=-4.430、P=0.001;t=-5.530、P=0.001)。结论:与开放手术治疗相比,腹腔镜治疗腹股沟斜疝引起IL-1β、Ig改变的较小,因而,腹腔镜手术对小儿机体的免疫抑制作用小,持续时间短。
Objective: To investigate the changes of interleukin-1β (IL-1β), immunoglobulin A, G, M (IgA, IgG, IgM) in peripheral blood before and after laparoscopic surgery for indirect inguinal hernia in children. Methods: Fifty cases of inguinal hernia were randomly divided into laparoscopic group and open group of 25 cases by random sampling. Laparoscopic group of abdominal loop hernia sac ligation; open group line inguinal hernia sac ligation. One week before surgery, fasting, immediately after surgery, on the morning of the second day after surgery, peripheral blood was collected fasting plasma IL-1β, IgM, IgA, IgG content by ELISA. Results: The levels of IL-1β, IgM, IgA and IgG immediately after operation in both groups were significantly higher than those before operation (laparoscopic group q = 11.307,22.111,24.161,23.111, P <0.05; open group q = 16.668,21.707, (T = -4.509, P = 0.000; t = -4.745, P = 0.000; t = 5.745, P = 0.000; t = 6.745, P = 0.000). There were no significant differences in IL-1β, IgM, IgA and IgG in the laparoscopic group at the second day after operation (q = 0.482, 3.853, 4.653, 4.853, P> 0.05) Preoperative (q = 10.599, 11.379, 10.768, 12.379, P <0.05). (T = -5.051, P = 0.000; t = -3.730, P = 0.001; t = -4.430, P = 0.001; t = -5.530, P = 0.001) in the open group compared with the open group . Conclusion: Compared with open surgery, laparoscopic inguinal hernia caused by small changes in IL-1β, Ig, therefore, laparoscopic surgery in children with small immunosuppressive effect, short duration.