腹腔镜阑尾切除术对妊娠期阑尾炎患者术后胃肠功能及免疫应激的影响  

Effect of Laparoscopic Appendectomy on Gastrointestinal Function and Immune Stress in Patients with Appendicitis during Pregnancy

作　　者：方荣臻 林少露 FANG Rongzhen;LIN Shaolu(Zhangzhou Chinese Medicine Hospital,Zhangzhou 363099,China;不详)

机构地区：[1]漳州市中医院,福建漳州363099 [2]漳州市福康医院

出　　处：《中外医学研究》2022年第4期125-128,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨腹腔镜阑尾切除术(LA)在妊娠期阑尾炎患者中的应用价值。方法:选择2019年1月-2021年1月漳州市中医院收治的妊娠期阑尾炎患者100例。按随机数字表法分为对照组和观察组,各50例。对照组实施传统开腹阑尾切除术(OA),观察组采取LA。对比两组胃肠功能恢复情况、免疫功能、炎症反应及并发症。结果:观察组肠鸣音恢复、初次肛门排气及初次排便时间均早于对照组,差异有统计学意义(P<0.05);两组术前辅助性T淋巴细胞(CD4^(+))、抑制性T淋巴细胞(CD8^(+))、CD4^(+)/CD8^(+)相比,差异均无统计学意义(P>0.05);对照组术后CD4^(+)、CD4^(+)/CD8^(+)均低于术前,CD8^(+)高于术前,且术后CD4^(+)、CD4^(+)/CD8^(+)均低于观察组,CD8^(+)高于观察组,差异有统计学意义(P<0.05);观察组术前、术后CD8^(+)、CD4^(+)/CD8^(+)比较,差异均无统计学意义(P>0.05);两组术前肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白介素-6(IL-6)水平相比,差异均无统计学意义(P>0.05);观察组术后TNF-α、CRP、IL-6水平均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:LA创伤较小,可有效促进妊娠期阑尾炎患者术后胃肠功能恢复,减轻机体炎症反应,且对机体免疫功能影响较小,安全可靠。Objective:To explore the application value of laparoscopic appendectomy(LA)in patients with appendicitis during pregnancy.Method:A total of 100 patients appendicitis during pregnancy admitted to Zhangzhou Chinese Medicine Hospital from January 2019 to January 2021 were selected.According to the random number table method,they were divided into control group and observation group,50 cases in each group.The control group received traditional open appendectomy(OA),and the observation group received LA.Gastrointestinal function recovery condition,immune function,inflammatory response and complications were compared between the two groups.Result:The recovery time of bowel sounds,the time of first anal exhaust and first defecation in the observation group were earlier than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in helper T lymphocytes(CD4^(+)),inhibitory T lymphocytes(CD8^(+))and CD4^(+)/CD8^(+)before surgery between the two groups(P>0.05).In the control group,postoperative CD4^(+)and CD4^(+)/CD8^(+)were lower than before surgery,while CD8^(+)was higher than before surgery,and postoperative CD4^(+)and CD4^(+)/CD8^(+)were lower than observation group,while CD8^(+)was higher than observation group,the differences were statistically significant(P<0.05).There were no significant differences in CD8^(+),CD4^(+)/CD8^(+)between the observation group before and after surgery(P>0.05).There were no significant differences in the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)before surgery between the two groups(P>0.05).After surgery,the levels of TNF-α,CRP and IL-6 in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:LA has little trauma,and can effectively promo

关 键 词：妊娠期阑尾炎 腹腔镜阑尾切除术 传统开腹阑尾切除术 胃肠功能 炎症反应 

分 类 号：R656.8[医药卫生—外科学]