不同入路通道经脐单孔腹腔镜手术治疗非创伤性急腹症的效果  

Efficacy of Transumbilical Single-Incision Laparoscopic Surgery via Different Access Portals in the Treatment of Non-Traumatic Acute Abdomen

作　　者：曾新宇 张凌楠 ZENG Xin-yu;ZHANG Ling-nan(Fangcheng People's Hospital,Nanyang,473299,Henan)

机构地区：[1]方城县人民医院,河南南阳473299

出　　处：《黔南民族医专学报》2024年第2期142-145,共4页Journal of Qiannan Medical College for Nationalities

摘　　要：目的:探讨不同入路通道经脐单孔腹腔镜手术治疗非创伤性急腹症的效果。方法:将本院收治的87例非创伤性急腹症患者依据随机数字表法分为两组;两组患者均给予术前准备,常规组(43例)行常规腹腔镜手术治疗,经脐组(44例)行经脐单孔腹腔镜手术治疗;观察两组患者手术相关指标、血清细胞因子水平、疼痛程度、生活质量恢复情况及并发症发生率。结果:两组患者手术时间及术中出血量比较无统计学意义(P>0.05),经脐组术后排气时间、术后进食时间、卧床时间及住院时间短于常规组(P<0.05);术后,经脐组TNF-α、IL-6、hs-CRP水平均低于常规组(P<0.05);术后1、2、3 d,两组患者的视觉模拟(VAS)评分均下降,且经脐组低于常规组(P<0.05);经脐组并发症发生率4.54%低于常规组20.92%(P<0.05)。结论:非创伤性急腹症患者采用经脐单孔腹腔镜手术治疗可以提高各项手术指标,减轻炎症水平,缓解疼痛,降低并发症的发生。Objective:To investigate the efficacy of transumbilical single-incision laparoscopic surgery(SILS)via different access portals in treating non-traumatic acute abdomen.Methods:Eighty-seven patients with non-traumatic acute abdomen admitted to our hospital were randomly divided into two groups using a random number table;both groups received preoperative preparations,with the control group(43 cases)undergoing conventional laparoscopic surgery and the transumbilical group(44 cases)receiving transumbilical SILS.Parameters related to surgery,serum cytokine levels,pain intensity,quality of life recovery,and complication rates were observed in both groups.Results:There was no statistically significant difference in operative time or intraoperative blood loss between the two groups(P>0.05).However,the transumbilical group had shorter times to first flatus,oral intake resumption,mobilization,and hospital stay compared to the control group(P<0.05).Postoperatively,TNF-α,IL-6,and hs-CRP levels were lower in the transumbilical group than in the control group(P<0.05).Visual Analog Scale(VAS)scores decreased on postoperative days 1,2,and 3 for both groups,with the transumbilical group reporting less pain(P<0.05).The compl-ication rate was lower in the transumbilical group(4.54%)compared to the control group(20.92%,P<0.05).Conclusion:Transumbilical SILS for non-traumatic acute abdomen improves surgical outcomes,reduces inflammatory responses,alleviates pain,and decreases the incidence of complications.

关 键 词：不同入路通道 经脐单孔腹腔镜手术 非创伤性急腹症 血清细胞因子 

分 类 号：R656.1[医药卫生—急诊医学]