电视辅助胸腔镜技术治疗胸外伤手术前后IL-2与IL-10的变化

目的：通过炎性因子的变化来探讨电视辅助胸腔镜技术（VAST）对胸外伤手术治疗的价值。方法：2004年6月-2006年6月本院收治胸外伤患者76例，随机分为VAST辅助手术组（简称VAST组）和常规开胸手术组（简称对照组），其中VAST组40例，对照组36例。对比检测患者手术前、手术后即刻、术后第1、2、3天的白介素2（IL-2）与白介素（IL-10）变化，并进行重复测量数据分析。结果：两组患者术后均恢复良好，无死亡病例。术前两组IL-2含量无统计学差异，手术后即刻、术后第1、2、3天VAST组IL-2含量（161．01±32．52，156．04±19．77，157．30±23．16，148．42±41．78）ng／L均小于对照组（P〈0．05）；两组IL-10含量在手术前及手术后即刻差异无统计学意义，但术后第1、2、3天VAST组IL-10含量（91．07±13．53，91．89±12．23，85．11±9．71）ng／L均大于对照组（P〈0．05）。结论：VAST辅助开胸手术方法对胸外伤伤者创伤程度小于常规开胸手术。

Profiles of IL-2 and IL-10 in Chest Trauma before and after Treated with Video-Assisted Thoracoscopic Surgery

Objective： To explore the value of video-assisted thoracic surgery （VATS） for treatment of chest trauma based on the profiles of inflammatory cytokines. Methods：From June 2004 to June 2006, 76 victims from chest trauma received operations which included VATS and conventional open chest surgery randomly assigned to two groups （the VATS group, n=40; the control group, n=36）. Serum IL-2 and IL-10 were determined respectively before operation, immediately after operation, at days 1 to 3 after operation, followed by repeated measures analysis. Results： The patients recovered uneventfully and no death was reported. While the levels of IL-2 did not differ statistically between the two groups before operation, immediately after operation and at days 1 to 3, VATS group showed lower levels of IL-2 （161.01±32.52, 156.04±19.77, 157.30±23.16 and 148.42±41.78）ng/L as compared with controls （P〈0.05）. Higher levels of IL-10 （91.07±13.53, 91.89±12.23, 85.11±9.71 ）ng/L were also shown in VATS group at days 1 to 3 （P〈0.05） but not before and immediately after operation. Conclusion： VATS appears less invasive than traditional approach for patients with chest trauma.