腹腔镜与开腹手术治疗根部坏疽穿孔性阑尾炎患者的效果比较  

Comparison of the Effect of Laparoscopy and Open Surgery in the Treatment of Patients with Root Gangrenous Perforated Appendicitis

作　　者：陈新闯 马钊[2] 谷军保[2] CHEN Xinchuang;MA Zhao;GU Junbao(Surgery,Suiyang District Hospital of Traditional Chinese Medicine in Shangqiu,Shangqiu 476100,China;Gastrointestinal Surgery,Henan Provincial People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]商丘市睢阳区中医院外科,河南商丘476100 [2]河南省人民医院胃肠外科,河南郑州450000

出　　处：《河南医学研究》2022年第12期2202-2205,共4页Henan Medical Research

摘　　要：目的比较腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)治疗根部坏疽穿孔性阑尾炎患者的效果。方法选取2017年1月至2020年12月商丘市睢阳区中医院收治的102例根部坏疽穿孔性阑尾炎患者。按随机数表法将患者分成A组(51例)和B组(51例)。A组患者接受OA治疗,B组患者接受LA治疗。比较两组围手术期指标、术后并发症发生率以及术前、术后1d阑尾炎炎症反应量表(AIR)、视觉模拟评分法(VAS)评分、皮质醇(Cor)、促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)水平。结果B组手术时长、肛门排气时间、进食时间、术后下床活动时间、住院时长及胃肠功能恢复时间较A组短,术中失血量较A组少(P<0.05)。术后1 d,两组AIR、VAS评分均较术前降低,B组AIR、VAS评分均较A组低(P<0.05)。术后1 d,两组血清NE、Cor、ACTH水平均较术前升高,B组血清NE、Cor、ACTH水平较A组低(P<0.05)。B组术后并发症总发生率较A组低(P<0.05)。结论与OA治疗根部坏疽穿孔性阑尾炎患者相比,应用LA的治疗效果更显著,有助于优化围手术期指标,缓解术后疼痛感,减轻术后应激反应,降低术后并发症发生风险。Objective To compare the effects of laparoscopic appendectomy(LA)and open appendectomy(OA)in the treatment of appendicitis with gangrenous root and perforation.Methods From January 2017 to December 2020,102 patients with perforated appendicitis with root gangrene were selected.The patients were randomly divided into group A(51 cases)and group B(51 cases).The patients in group A were treated with OA,while the patients in group B were treated with LA.Perioperative indicators,postoperative complications,and appendicitis inflammatory response scale(AIR),visual analogue scale(VAS),cortisol(Cor),adrenocorticotropic hormone(ACTH)and norepinephrine(NE)levels before and 1 day after operation were compared between the two groups.Results Compared with group A,the operation duration,anal exhaust time,eating time,getting out of bed after operation,hospitalization time and gastrointestinal function recovery time in group B were shorter,and the intraoperative blood loss was less than that in group A(P<0.05).On the 1st day after operation,the scores of AIR and VAS in both groups were lower than those before operation,and those in group B were lower than those in group A(P<0.05).On the 1st day after operation,the levels of serum NE,Cor and ACTH in both groups were higher than those before operation,while those in group B were lower than those in group A(P<0.05).The total incidence of postoperative complications in group B was lower than that in group A(P<0.05).Conclusion Compared with OA in the treatment of root gangrene and perforated appendicitis,LA has a more significant therapeutic effect,which is helpful to optimize perioperative indicators,relieve postoperative pain,relieve postoperative stress response and reduce the risk of postoperative complications.

关 键 词：根部坏疽穿孔性阑尾炎 阑尾切除术 腹腔镜 开腹手术 

分 类 号：R656.8[医药卫生—外科学]