微创腔镜与传统开腹手术治疗阑尾穿孔腹膜炎脓毒症患儿的效果对比  

Effect comparison of minimally invasive endoscope and traditional laparotomy in the treatment of children with appendiceal perforated peritonitis and sepsis

作　　者：谭长春[1] 陈太忠[1] 李光亮[1] 刘波[1] 刘星[1] 段少强 TAN Chang-chun;CHEN Tai-zhong;LI Guang-liang;LIU Bo;LIU Xing;DUAN Shao-qiang(Department of Pediatric Surgery,Yongchuan Hospital Affiliated to Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院儿外科

出　　处：《中国当代医药》2019年第14期134-136,共3页China Modern Medicine

摘　　要：目的比较微创腔镜与传统开腹手术治疗阑尾穿孔腹膜炎脓毒症患儿的效果。方法选取2016年4月~2018年4月在我院外科治疗的82例小儿阑尾穿孔腹膜炎脓毒症患儿,随机分为对照组与观察组,每组各41例。对照组采用传统开腹手术,观察组采用微创腔镜,比较两组患者的各项手术指标、炎性因子水平变化、并发症总发生率。结果观察组的手术时间、术后排气时间、下床活动时间、进食时间、住院时间均明显短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组术后的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均明显低于对照组,而白介素-10(IL-10)水平明显高于对照组,差异有统计学意义(P<0.05)。观察组的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论微创腔镜在小儿阑尾穿孔腹膜炎脓毒症中的应用效果更佳,能彻底切除阑尾,清除腹腔内炎症,降低机体炎性因子水平,减少并发症的发生,加快术后恢复速度,具有积极的临床意义。Objective To compare the efficacy of minimally invasive laparoscope and traditional laparotomy in the treatment of children with appendiceal perforation peritonitis sepsis. Methods A total of 82 pediatric patients with sepsis of perforated peritonitis from April 2016 to April 2018 were selected and randomly divided into the control group and the observation group,41 cases in each group. The control group received traditional laparotomy,and the observation group received minimally invasive endoscope. The surgical indicators,inflammatory factor levels and the total incidence rate of complications of the two groups were compared. Results The operation time,postoperative exhaust time,bed activity time,feeding time and hospitalization time of the observation group were significantly shorter than those of the control group,and intraoperative blood loss of the observation group was less than that of the control group,with statistically significant differences (P<0.05). The levels of interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) in the observation group were significantly lower than those of the control group,while the level of interleukin-10 (IL-10) in the observation group was significantly higher than that in the control group,with statistically significant differences (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group,with significant difference (P<0.05). Conclusion Minimally invasive endoscope is more effective in the application of sepsis of perforated peritonitis in children,which can completely remove the appendix,remove the intra-abdominal inflammation,reduce the level of inflammatory factors,reduce the occurrence of complications,and speed up the postoperative recovery,it has positive clinical significance.

关 键 词：小儿阑尾穿孔腹膜炎脓毒症 微创腔镜 传统开腹手术 应用分析 

分 类 号：R726[医药卫生—儿科]