免气腹单孔腹腔镜切除术对阑尾炎患儿应激反应及康复效果的影响  

The impact of gasless one-port laparoscopic appendectomy for children with appendicitis on stress response and recovery effect

作　　者：杨军[1] 余世万 孙凯 张龙 魏延青 向远超 刘娟[1] YANG Jun;YU Shi-wan;SUN Kai;ZHANG Long;WEI Yan-qing;XIANG Yuan-chao;LIU Juan(Department of Pediatric Surgery,Nanyang Second General Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市第二人民医院小儿外科,河南南阳473000

出　　处：《实用医院临床杂志》2020年第3期92-94,共3页Practical Journal of Clinical Medicine

基　　金：河南省医学科技攻关计划项目(编号:2018020988)。

摘　　要：目的探讨免气腹单孔腹腔镜切除术(laparoscope appendectomy,LA)对急性阑尾炎(acute appendicitis,AA)患儿应激反应及康复效果的影响。方法选择2017年3月至2018年10月我院收治的90例AA患儿,根据手术方式分为免气腹单孔腹腔镜组(免气腹组)47例、气腹单孔腹腔镜组(气腹组)43例。免气腹组给予免气腹单孔LA,气腹组给予单孔气腹LA,比较两组手术相关指标、应激反应、并发症等。结果免气腹组患儿手术时间长于气腹组,术后下床活动时间、术后肛门排气时间、住院时间短于气腹组(P<0.05,P<0.01);术后24 h免气腹组患儿血清去甲肾上腺素、皮质醇、血糖低于气腹组(P<0.05);并发症发生率低于气腹组(P<0.05)。结论免气腹单孔腹腔镜切除术有助于缓解急性阑尾炎患儿应激反应程度,促进患儿康复,减少术后并症的发生。Objective To explore the effect of gasless one-port laparoscopic appendectomy(LA)for children with acute appendicitis(AA)on stress response and recovery effect.Methods Ninety AA children from March 2017 to October 2018 were divided into gasless one-port laparoscopic appendectomy group(gasless group,n=47)and gas one-port laparoscopic appendectomy group(gas group,n=43)according to the surgical methods.The gasless group gave gasless one-port LA,and the gas group given gas one-port LA.Then,surgical indicators,stress response,and complications were compared between the two groups.Results The operation time in the gasless group were longer than that in the gas group.The postoperative out-of-bed activity time,postoperative anal exhaust time,and hospitalization time in the gasless group were shorter than those in the gas group(P<0.05 and P<0.01).Serum noradrenaline,cortisol,blood glucose after 24 h of surgery were lower in the gasless group than those in the gas group(P<0.05).Complications in the gasless group was lower than that in the gas group(P<0.05).Conclusion Gasless one-port laparoscopic appendectomy help to relieve the stress response of children with acute appendicitis,promote the patient recovery,and reduce the postoperative complications.

关 键 词：阑尾炎 阑尾切除术 腹腔镜 单孔 免气腹 应激反应 

分 类 号：R656.8[医药卫生—外科学]