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电视胸腔镜手术对小儿纵隔肿瘤治疗中疼痛应激指标一氧化氮(NO)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的影响。

Effect of video-assisted thoracoscopic surgery on pain stress indicators NO, IL-1β and IL-6 in the treatment of mediastinal tumor in children.

作者信息

Zhai Bo, Zhang Yonghong, Chen Zhenliang, Yang Fang, Dong Xiangyang, Chen Zhongjian, Cui Yazhou, Wang Penggao, Shi Lei, Yu Wenbo

机构信息

Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan 450018, P.R. China.

出版信息

Oncol Lett. 2020 Jun;19(6):3931-3936. doi: 10.3892/ol.2020.11515. Epub 2020 Apr 6.

Abstract

This study aimed to investigate the effect of video-assisted thoracoscopic surgery (VATS) on pain stress indicators nitric oxide (NO), interleukin-1β (IL-1β) and IL-6 in the treatment of mediastinal tumor in children, so as to explore the clinical application value of this surgery. A retrospective analysis was performed on 82 children with mediastinal tumor undergoing operation in Children's Hospital Affiliated to Zhengzhou University from January 2012 to January 2016. Among them, 48 children undergoing VATS were enrolled as an observation group, and 34 children undergoing conventional thoracotomy were enrolled as a control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the preoperative and postoperative expression levels of NO, IL-1β and IL-6. The intraoperative clinical data, postoperative pain degree and infection rate were observed and recorded in real time, and then compared between the two groups. Before operation (T), there were no statistically significant differences between the two groups in serum NO, IL-1β and IL-6 expression levels, which were lower in the observation group than those in the control group at 12 h (T) and 24 h (T) after operation (P<0.05). The visual analog scale (VAS) score in the observation group was lower than that in the control group at T (P<0.05). Compared with the control group, the largest blade opening, intraoperative blood loss, drainage duration and postoperative pain degree were significantly improved in the observation group. The postoperative infection rate was 4.17% in the observation group, significantly lower than 17.64% in the control group. VATS is effective for postoperative pain stress indicators and infection control in children with mediastinal tumor, which is therefore more suitable for children with the disease and has a higher clinical value.

摘要

本研究旨在探讨电视胸腔镜手术(VATS)治疗小儿纵隔肿瘤时对疼痛应激指标一氧化氮(NO)、白细胞介素-1β(IL-1β)和IL-6的影响,以探讨该手术的临床应用价值。对2012年1月至2016年1月在郑州大学附属儿童医院接受手术的82例小儿纵隔肿瘤患者进行回顾性分析。其中,48例行VATS手术的患儿作为观察组,34例行传统开胸手术的患儿作为对照组。采用酶联免疫吸附测定(ELISA)法检测术前及术后NO、IL-1β和IL-6的表达水平。实时观察并记录术中临床资料、术后疼痛程度及感染率,然后对两组进行比较。术前(T0),两组血清NO、IL-1β和IL-6表达水平差异无统计学意义,术后12 h(T1)和24 h(T2)观察组低于对照组(P<0.05)。观察组视觉模拟评分(VAS)在T1时低于对照组(P<0.05)。与对照组相比,观察组最大切口长度、术中出血量、引流时间及术后疼痛程度均明显改善。观察组术后感染率为4.17%,明显低于对照组的17.64%。VATS对小儿纵隔肿瘤术后疼痛应激指标及感染控制有效,更适合该病患儿,具有较高的临床价值。

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