腹腔镜阑尾切除术治疗阑尾穿孔的临床预后情况评价  

Evaluation of the clinical prognosis of laparoscopic appendectomy for appendiceal perforation

作　　者：秦修强 QIN Xiu-qiang(Third Department of Surgery,Shandong Tengzhou Traditional Chinese Medicine Hospital(Workers'Hospital),Tengzhou 277500,China)

机构地区：[1]山东省滕州市中医医院(工人医院)外三科,277500

出　　处：《中国实用医药》2024年第19期48-51,共4页China Practical Medicine

摘　　要：目的 评价阑尾穿孔治疗中应用腹腔镜阑尾切除术的总体效果,分析患者预后情况,旨在帮助患者加快恢复速度,减轻治疗痛苦。方法 选取72例阑尾穿孔患者,应用奇偶分组法将患者分为参照组与试验组,每组36例。参照组实施开腹阑尾切除术,试验组实施腹腔镜阑尾切除术。比较两组临床相关指标、应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、炎症指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]及并发症发生率。结果 试验组术中出血量(20.78±5.32)ml比参照组的(50.64±6.28)ml更少,手术时间(62.28±10.27)min、术后肛门排气时间(42.68±8.14)h、体温恢复正常时间(31.01±1.25)h、住院时间(6.78±3.32)d均比参照组的(85.01±10.25)min、(62.69±8.13)h、(39.37±2.15)h、(10.64±3.28)d短(P<0.05)。术后24 h,与术前相比,两组MDA、IL-6、CRP、TNF-α均升高,但试验组低于参照组;两组SOD均降低,但试验组高于参照组(P<0.05)。试验组并发症发生率为8.33%,低于参照组的27.78%(P<0.05)。结论 腹腔镜阑尾切除术对改善阑尾穿孔患者临床预后作用显著,可减轻患者的应激反应,缓解其炎症程度,减少并发症发生率,加快胃肠功能恢复速度。Objective To evaluate the overall effect of applying laparoscopic appendectomy in the treatment of appendiceal perforation and analyze the prognosis of the patients,aiming to help the patients to speed up their recovery and reduce the pain of treatment.Methods A total of 72 patients with appendiceal perforation were selected and divided into a reference group and an experimental group by odd-even grouping method,with 36 cases in each group.The reference group underwent open appendectomy,and the experimental group underwent laparoscopic appendectomy.Both groups were compared in terms of clinical related indicators,stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA)],inflammatory indicators[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]and complication rate.Results The intraoperative blood loss of(20.78±5.32)ml in the experimental group was less than(50.64±6.28)ml in the control group;the experimental group had operation time(62.28±10.27)min,postoperative anal exhaust time of(42.68±8.14)h,time for temperature returned to normal of(31.01±1.25)h,and hospitalization time of(6.78±3.32)d,which were shorter than(85.01±10.25)min,(62.69±8.13)h,(39.37±2.15)h,and(10.64±3.28)d in the control group(P<0.05).24 h after surgery,MDA,IL-6,CRP and TNF-αwere increased in both groups,but the experimental group was lower than the reference group;SOD was decreased in both groups,but the experimental group was higher than the reference group(P<0.05).The complication rate of the experimental group was 8.33%,which was lower than 27.78%of the control group(P<0.05).Conclusion Laparoscopic appendectomy has a significant effect on improving the clinical prognosis of patients with appendiceal perforation,which can reduce the stress reaction of patients,alleviate the degree of their inflammation,reduce the incidence of complications,and accelerate the recovery of gastrointestinal function.

关 键 词：阑尾穿孔 腹腔镜阑尾切除术 开腹阑尾切除术 应激指标 炎症指标 

分 类 号：R656.8[医药卫生—外科学]