腔镜指导下的小切口阑尾切除术治疗急性阑尾炎患者的临床效果观察  

Clinical Observation of Small Incision Appendectomy Guided by Endoscopy in the Treatment of Acute Appendicitis Patients

作　　者：黄荣斌 HUANG Rongbin(Department of General Surgery,Zhenghe County Hospital,Nanping City,Fujian Province,Nanping 353600,China)

机构地区：[1]福建省南平市政和县医院普通外科,福建南平353600

出　　处：《中国医药指南》2023年第33期82-85,共4页Guide of China Medicine

摘　　要：目的研究对急性阑尾炎患者采取腔镜指导下小切口阑尾炎切除术的效果。方法于2021年3月至2023年3月我院急性阑尾炎患者中随机抽取62例,分为对照组(31例,采用常规手术)和观察组(31例,采用腹腔镜小切口阑尾切除术),对比两组疗效。结果观察组患者术中出血量(14.15±2.18)mL、切口长度(2.26±0.52)cm,低于对照组术中出血量(28.45±3.36)mL、切口长度(5.86±1.23)cm,P<0.05。观察组手术时间(105.36±15.21)min,略长于对照组手术时间(95.24±18.20)min;观察组下床时间(1.16±0.24)d、排气时间(15.78±1.54)h、住院时间(5.10±1.16)d,短于对照组下床时间(2.20±0.52)d、排气时间(21.18±2.16)h、住院时间(8.15±2.34)d,P<0.05。观察组CRP(6.37±0.51)mg/L、IL-6(14.26±1.71)pg/mL、TNF-α(1.96±0.30)μg/L,低于对照组CRP(8.50±0.55)mg/L、IL-6(19.17±1.94)pg/mL、TNF-α(2.72±0.27)μg/L,P<0.05。观察组VAS评分(1.32±0.60)、SF-36评分(77.32±4.82),优于对照组VAS评分(2.80±1.12)、SF-3评分(68.25±5.30),P<0.05。观察组出现并发症1例(3.23%),少于对照组8例(25.81%),(P<0.05)。结论采取腹腔镜小切口阑尾炎切除术治疗可有效减少出血量,减小手术切口,术后炎性反应、康复速度、疼痛程度及并发症均优于常规手术,更有利于加快术后康复速度,提高术后生活质量,有显著优势。Objective To study the effect of laparoscopic guided small incision appendectomy on patients with acute appendicitis.Method A total of 62 patients with acute appendicitis in our hospital from March 2021 to March 2023 were randomly selected.Divided into a control group(31 cases,conventional surgery)and an observation group(31 cases,laparoscopic small incision appendectomy).The therapeutic effects of the two groups were compared.Results The intraoperative bleeding volume(14.15±2.18)mL and incision length(2.26±0.52)cm in the observation group were lower than those in the control group intraoperative bleeding volume(28.45±3.36)mL and incision length(5.86±1.23)cm(P<0.05).The surgical time in the observation group was(105.36±15.21)minutes,slightly longer than that in the control group(95.24±18.20)minutes.The observation group had a shorter time of getting out of bed(1.16±0.24)days,exhaust time(15.78±1.54)hours,and hospitalization time(5.10±1.16)days compared to the control group(2.20±0.52)days,exhaust time(21.18±2.16)hours,and hospitalization time(8.15±2.34)days(P<0.05).Observation group CRP(6.37±0.51)mg/L,IL-6(14.26±1.71)pg/mL,TNF-α(1.96±0.30)μg/L,lower than the control group CRP(8.50±0.55)mg/L,IL-6(19.17±1.94)pg/mL,TNF-α(2.72±0.27)μg/L(P<0.05).The observation group had VAS(1.32±0.60)and SF-36(77.32±4.82)scores,which were better than the control group VAS(2.80±1.12)and SF-36(68.25±5.30)scores(P<0.05).A total of 1 case(3.23%)of complications occurred in the observation group,lower than the control group 8 cases(25.81%)(P<0.05).Conclusions Laparoscopic small incision appendectomy can effectively reduce bleeding,reduce surgical incision,and improve postoperative inflammatory response,recovery speed,pain level,and complications compared to conventional surgery.It is more conducive to accelerating postoperative recovery speed,improving postoperative quality of life,and has significant advantages.

关 键 词：急性阑尾炎 腹腔镜小切口阑尾切除术 炎症指标 疼痛程度 并发症 

分 类 号：R656.8[医药卫生—外科学]