腹腔镜阑尾切除术与传统开腹手术治疗阑尾炎合并盆腔炎的效果比较  

Effect comparison of laparoscopic appendectomy and open appendectomy in the treatment of appendicitis complicated with pelvic inflammatory disease

作　　者：赵健全 杨军[1] 陈辰 吕进 ZHAO Jianquan;YANG Jun;CHEN Chen;LYU Jin(The Second Department of General Surgery,Qidong People’s Hospital,Jiangsu Province,Qidong 226200,China)

机构地区：[1]江苏省启东市人民医院普外二科,江苏启东226200

出　　处：《妇儿健康导刊》2022年第6期16-20,共5页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的对比腹腔镜阑尾切除术(LA)与传统开腹手术(OA)治疗阑尾炎合并盆腔炎的效果。方法选取启东市人民医院普外科于2020年1月至2021年12月收治的60例阑尾炎合并盆腔炎患者为观察对象,按随机数字表法分为LA组和OA组,每组各30例。LA组患者接受LA手术治疗,OA组患者接受OA手术治疗,比较两种不同手术方法对阑尾炎合并盆腔炎患者的治疗效果。结果LA组患者的手术时间、术后住院时间、术后下床活动时间、术后排气时间、术后体温恢复正常时间、胃肠道功能恢复时间、术后留置引流管时间短于OA组,差异均有统计学意义(P<0.05)。LA组患者的手术切口短于OA组,术中出血量少于OA组,术后24 h疼痛视觉模拟评分(VAS)低于OA组,差异均有统计学意义(P<0.05)。LA组患者术后的并发症总发生率低于OA组,差异有统计学意义(P<0.05)。两组患者术后24 h血清炎症因子白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平高于术前,LA组患者术后24 h血清炎症因子IL-6、IL-8、TNF-α水平低于OA组,差异均有统计学意义(P<0.05);两组患者术前的血清炎症因子IL-6、IL-8、TNF-α水平比较,差异无统计学意义(P>0.05)。结论与OA治疗阑尾炎合并盆腔炎比较,LA在降低手术风险、改善预后效果、减少术后并发症发生、降低术后血清炎症因子水平上升幅度等方面有明显优势,临床对于符合相应条件的患者应优先选择LA治疗。Objective To compare the effect of laparoscopic appendectomy(LA)and open appendectomy(OA)in the treatment of appendicitis complicated with pelvic inflammatory disease.Methods A total of 60 patients with appendicitis complicated with pelvic inflammatory disease who were admitted to the Department of General Surgery of Qidong People’s Hospital from January 2020 to December 2021 were selected as observation objects,and divided into LA group and OA group by random number table method,30 cases in each group.The patients in the LA group were treated with LA surgery,and the patients in the OA group were treated with OA surgery.The therapeutic effects of two different surgical methods on patients with appendicitis and pelvic inflammatory disease were compared.Results The operation time,postoperative hospitalization time,postoperative ambulation time,postoperative exhaust time,postoperative body temperature return to normal time,gastrointestinal function recovery time,postoperative indwelling drainage tube time in the LA group were shorter than those in the OA group,the differences were statistically significant(P<0.05).The length of incision in the LA group was shorter than that in the OA group,the intraoperative blood loss was less than that in the OA group,the visual analogue scale(VAS)at 24 hours after the operation was lower than that in the OA group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the LA group was lower than that in the OA group,the difference was statistically significant(P<0.05).The serum inflammatory factors interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in the two groups at 24 hours after surgery were higher than those before surgery,the levels of IL-6,IL-8 and TNF-αin the LA group were lower than those in the OA group,the differences were statistically significant(P<0.05).The preoperative serum inflammatory factors IL-6,IL-8 and TNF-αlevels in the two groups had no significant differences(P>0.05).Conclus

关 键 词：阑尾炎合并盆腔炎 腹腔镜 阑尾切除术 疗效比较 

分 类 号：R656.8[医药卫生—外科学]