阑尾炎并发全身炎性反应综合征患者应用腹腔镜手术治疗后对其血清CRP及临床指标的影响  

The Effect of Laparoscopic Surgery on Serum CRP and Clinical Parameters in Patients with Appendicitis Complicated with Systemic Inflammatory Response Syndrome

作　　者：陈权彬 辜树勇 杨逸峰 

机构地区：[1]广东省潮州市潮安区人民医院,广东潮州515600

出　　处：《中国医学创新》2017年第12期12-15,共4页Medical Innovation of China

基　　金：潮州市卫生局科研项目(潮卫科研201564)

摘　　要：目的:探讨阑尾炎并发全身炎性反应综合征(SIRS)患者应用腹腔镜手术治疗后对其血清C-反应蛋白(CRP)及临床指标的影响。方法:选取2014年3月-2016年4月本院收治的阑尾炎并发全身炎性反应综合征患者76例,按不同手术方式分为腹腔镜阑尾切除术(LA)组40例和开腹阑尾切除术(OA)组36例。比较两组的术中出血量、术后切口感染率、腹腔脓肿发生率、腹腔引流量、SIRS症状改善时间、肛门恢复排气时间、住院时间。结果:LA组的术中出血量、术后切口感染率、腹腔脓肿发生率、腹腔引流量、SIRS症状改善时间、肛门恢复排气时间、住院时间均少于OA组,差异均有统计学意义(P<0.05)。术后1 d,两组患者的血清CRP水平均明显高于术前,且LA组的CRP水平低于OA组,差异均有统计学意义(P<0.001)。术后3 d,两组的血清CRP水平均有所下降,且LA组的血清CRP下降幅度大于OA组,差异均有统计学意义(P<0.001)。结论:腹腔镜阑尾切除术具有创伤小、恢复快、并发症少等优势,能有效的彻底清除腹腔内感染病灶,缓解患者SIRS症状,缩短住院时间,提高患者生活质量。Objective： To investigate the effect of laparoscopic surgery on the serum CRP and clinical parameters in patients with appendicitis complicated with systemic inflammatory response syndrome （ SIRS ） . Method： 76 cases with appendicitis complicated with systemic inflammatory response syndrome in our hospital from March 2014 to April 2016 were selected, according to the different operation methods, they were divided into laparoscopie appendectomy （ LA ） group of 40 cases and open appendectomy （ OA ） group of 36 cases.The bleeding volume, postoperative incision infection rate, the incidence of abdominal abscess, the rate of abdominal drainage, the improvement of SIRS symptoms, the time of recovery of the anus, and the length of hospital stay were compared between the two groups.Result： The intraoperative bleeding, postoperative incision infection rate, incidence of abdominal abscess, abdominal drainage, SIRS symptom improvement time, anal exhaust time, hospitalization time of LA group were less than those of OA group, the differences were statistically significant （ P〈0.05 ） ; 1 day after the operation, the serum CRP levels of two groups were significantly higher than those before operation, and the CRP level of LA group was lower than that of LA group, the differences were statistically significant （ P〈0.O01 ） ; 3 days after the operation, the serum CRP levels of two groups were decreased, and the serum CRP level in LA group decreased more than that of OA group, the differences were statistically significant （P〈0.001） .Conclusion： Laparoscopie appendectomy has the advantages of less trauma, faster recovery, less complications and so on, it can effectively eliminate the infection of the abdominal cavity, relieve the symptoms of SIRS, shorten the length of hospital stay and improve the quality of life of patients.

关 键 词：阑尾炎 全身炎性反应综合征 腹腔镜阑尾切除术 C-反应蛋白 

分 类 号：R656.8[医药卫生—外科学]