腹腔镜下逆行阑尾切除术对急性阑尾炎患者术后康复及血清炎症因子水平的影响  

Effect of retrograde laparoscopic appendectomy on postoperative rehabilitation and serum inflammatory factor levels in patients with acute appendicitis

作　　者：张宏德 叶国曙 刘浩 ZHANG Hongde;YE Guoshu;LIU Hao(Department of Emergency Surgery,Qichun County People's Hospital,Huanggang,Hubei,435300,China;Department of Emergency,Qichun County People's Hospital,Huanggang,Hubei,435300,China;Department of Urinary surgery,Qichun County People's Hospital,Huanggang,Hubei,435300,China)

机构地区：[1]蕲春县人民医院急诊外科,湖北黄冈435300 [2]蕲春县人民医院急诊科,湖北黄冈435300 [3]蕲春县人民医院泌尿外科,湖北黄冈435300

出　　处：《当代医学》2023年第6期151-153,共3页Contemporary Medicine

摘　　要：目的分析腹腔镜下逆行阑尾切除术对急性阑尾炎患者术后康复及血清炎症因子水平的影响。方法回顾性分析2019年6月-2020年10月于本院接收治疗的96例急性阑尾炎患者的临床资料,依据治疗方案不同分为逆行组与开腹组,每组48例。开腹组接受传统开腹手术,逆行组接受腹腔镜下逆行阑尾切除术,比较两组围手术期指标及手术前后血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平。结果逆行组术中出血量少于开腹组,住院时间、手术时间、下床活动时间均短于开腹组,差异有统计学意义(P<0.05)。两组血清IL-6、TNF-α水平组间、时间、交互作用差异有统计学意义(P<0.05);组内比较:术后1、3 d,两组血清IL-6、TNF-α水平均高于前一时点,差异有统计学意义(P<0.05);组间比较:术后1、3 d,逆行组血清IL-6、TNF-α水平均低于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜下逆行阑尾切除术治疗急性阑尾炎患者,可缩短手术时间、住院时间、下床活动时间,减少术中出血量,抑制炎症反应。Objective To analyze the effect of retrograde laparoscopic appendectomy on postoperative rehabilitation and serum inflammatory factors levels in patients with acute appendicitis.Methods The clinical data of 96 patients with acute appendicitis who were treated in our hospital from June 2019 to October 2020 were retrospectively analyzed,and they were divided into the retrograde group and the laparotomy group according to different treatment schemes,with 48 cases in each group.The laparotomy group received traditional laparotomy,and the retrograde group received laparoscopic retrograde appendectomy,the perioperative indicators and serum inflammatory factors(interleukin-6[IL-6],and tumor necrosis factor-α[TNF-α])levels before and after surgery were compared between the two groups.Results The intraoperative blood loss in the retrograde group was less than that in the laparotomy group,and the hospitalization time,operation time and ambulation time were shorter than those in the laparotomy group,the differences were statistically significant(P<0.05).There were significant differences in serum IL-6 and TNF-αlevels between groups of group,time point and interaction(P<0.05);comparison within group:at 1 and 3 d after operation,the serum levels of IL-6 and TNF-αin the two groups were higher than those at the previous point,and the differences were statistically significant(P<0.05).Comparison between groups:at 1 and 3 d after operation,the serum levels of serum IL-6 and TNF-αin the retrograde group were lower than those in the laparotomy group,and the differences were statistically significant(P<0.05).Conclusion Laparoscopic retrograde appendectomy in the treatment of patients with acute appendicitis can reduce the operation time,hospitalization time,ambulation time,reduce intraoperative blood loss and inhibit inflammatory reaction.

关 键 词：腹腔镜下逆行阑尾切除术 开腹手术 急性阑尾炎 炎症反应 

分 类 号：R656.8[医药卫生—外科学]