经脐单孔腹腔镜阑尾切除术治疗小儿复杂性阑尾炎疗效及对血清CRP、IL-6、PCT和Alvarado评分的影响  

Efficacy of transumbilical single-port laparoscopic appendectomy in the treatment of children with complicated appendicitis and its influence on serum CRP,IL-6,PCT and Alvarado score

作　　者：陈亮[1] 伍兵[1] 罗由平 CHEN Liang;WU Bing;LUO You-ping(Department of Pediatric Surgery,the Second People s Hospital of Yibin,Yibin Hospital of West China Hospital,Sichuan University,Yibin 644000,Sichuan,China)

机构地区：[1]四川大学华西医院宜宾医院·宜宾市第二人民医院小儿外科,四川宜宾644000

出　　处：《川北医学院学报》2022年第10期1264-1267,共4页Journal of North Sichuan Medical College

基　　金：四川省卫健委科研课题(19PJ301)。

摘　　要：目的:分析经脐单孔腹腔镜阑尾切除术治疗小儿复杂性阑尾炎的疗效。方法:复杂性阑尾炎患儿136例,根据不同治疗方式分为观察组和对照组,每组各68例。对照组接受常规开腹阑尾切除术,观察组接受经脐单孔腹腔镜阑尾切除术。比较两组的围术期恢复状况;比较两组术前1 h及术后24、48 h的血清炎性因子水平;比较两组术前1 d及术后3、5 d时的疼痛状况;比较两组术前及术后3 d时的Alvarado评分,记录术后并发情况。结果:观察组术中出血量、术后首次肛门排气时间及平均住院时间均低于对照组(P<0.05);两组手术时间及术后并发症发生率比较,差异均无统计学意义(P>0.05);两组术后3、5 d时的VAS评分均低于术前,且观察组低于对照组(P<0.05);两组术后24 h的血清CRP、IL-6、PCT水平较术前升高,且对照组高于观察组(P<0.05),两组术后48 h的上述指标较术后24 h降低,且观察组低于对照组(均P<0.05);两组术前及术后3 d的Alvarado评分比较,差异无统计学意义(P>0.05)。结论:与常规开腹阑尾切除术相较,经脐单孔腹腔镜阑尾切除术治疗小儿复杂性阑尾炎创伤小,恢复快。Objective:To analyze the efficacy of transumbilical single-port laparoscopic appendectomy in the treatment of children with complicated appendicitis.Methods:136 children with complicated appendicitis were divided into observation group and control group according to the treatment methods,with 68 cases in each group.The control group was treated with routine open appendectomy,and the observation group received transumbilical single-port laparoscopic appendectomy.The perioperative recovery status,levels of serum inflammatory factors at 1 h before surgery and at 24 h and 48 h after surgery,pain status at 1 d before surgery and at 3 d and 5 d after surgery and Alvarado score before surgery and at 3 d after surgery were compared between the two groups,and the postoperative complications were recorded.Results:The intraoperative blood loss,postoperative first anal exhaust time and average hospital stay in observation group were significantly less or shorter than those in control group(P<0.05).There were no statistically significant differences in the surgical time and incidence rates of postoperative complications between the two groups(P>0.05).The VAS scores of the two groups at 3 d and 5 d after surgery were significantly lower than those before surgery,and the score of observation group was significantly lower compared with that of control group(P<0.05).The levels of serum CRP,IL-6 and PCT of the two groups at 24 h after surgery were significantly increased compared to before surgery,and the levels were significantly higher in control group than those in observation group(P<0.05),and the above indicators at 48 h after surgery in the two groups were significantly reduced compared with those at 24 h after surgery,and the indicators of observation group were significantly lower compared to control group(P<0.05).There were no statistical differences in the Alvarado scores before surgery and at 3 d after surgery between the two groups(P>0.05).Conclusion:Compared with routine open appendectomy,transumbilical single-port la

关 键 词：经脐单孔腹腔镜阑尾切除术 小儿复杂性阑尾炎 Alvarado评分 

分 类 号：R574.61[医药卫生—消化系统]