经脐单孔腹腔镜阑尾切除术治疗小儿急性阑尾炎的效果及对炎性反应的影响  

The Effect of Transumbilical Single-Port Laparoscopic Appendectomy on the Treatment of Acute Appendicitis in Children and Its Impact on Inflammatory Response

作　　者：陈培君 吴长鑫 杨甲辰 CHEN Peijun;WU Changxin;YANG Jiachen(Department of Pediatric Surgery,Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian),Quanzhou,Fujian,362200,China)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院)小儿外科,福建泉州362200

出　　处：《中外医疗》2024年第28期14-17,22,共5页China & Foreign Medical Treatment

摘　　要：目的将经脐单孔腹腔镜阑尾切除术用于小儿急性阑尾炎治疗中,探究其治疗效果及对炎性反应的影响。方法回顾性选取2021年6月—2023年7月晋江市医院(上海市第六人民医院福建医院)收治的99例急性阑尾炎患儿的临床资料,根据手术方法不同分为对照组(51例)和观察组(48例)。对照组采取传统腹腔镜手术,观察组实施经脐单孔腹腔镜阑尾切除术,对比两组患儿的手术指标、炎性因子水平、术后并发症发生情况。结果观察组患儿的术中出血量、术后肛门排气时间、进食及下床活动时间相比均优于对照组,差异有统计学意义(P均<0.05)。两组患儿的手术时间对比,差异无统计学意义(P>0.05)。术前,两组患儿的C反应蛋白(C-reactive protein,CRP)、白细胞计数(white blood cell count,WBC)、白细胞介素-6(interleukin-6,IL-6)水平对比,差异无统计学意义(P均>0.05);术后,观察组CRP水平、WBC水平、IL-6水平均低于对照组,差异有统计学意义(P均<0.05)。观察组并发症总发生率为2.08%(1/48),低于对照组的13.73%(7/51),差异有统计学意义(χ^(2)=4.512,P<0.05)。结论对急性阑尾炎患儿而言,应用经脐单孔腹腔镜阑尾切除术治疗可缩短术后活动时间,促进术后康复,且手术创伤较小,可降低炎性反应水平,减少并发症发生。Objective To explore the therapeutic effect of transumbilical single-port laparoscopic appendectomy in the treatment of acute appendicitis in children and its effect on inflammatory response.Methods The clinical data of 99 children with acute appendicitis admitted to Jinjiang Hospital(Shanghai Sixth People's Hospital Fujian)from June 2021 to July 2023 were retrospectively selected.According to different surgical methods,they were divided into control group(51 cases)and observation group(48 cases).The control group was treated with traditional laparoscopic surgery,and the observation group was treated with transumbilical single-port laparoscopic appendectomy.The surgical indicators,inflammatory factor levels,and postoperative complications were compared between the two groups.Results The intraoperative blood loss,postoperative anal exhaust time,eating and ambulation time of the two groups were better than those of the observation group,and the differences were statistically significant(all P<0.05).There was no significant difference in the operation time between the two groups(P>0.05).Before operation,there was no significant difference in the levels of C-reactive protein(CRP),white blood cell count(WBC)and interleukin-6(IL-6)between the two groups(all P>0.05).After operation,the levels of CRP,WBC and IL-6 in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The total incidence of complications in the observation group was 2.08%(1/48),which was lower than 13.73%(7/51)in the control group,and the difference was statistically significant(χ^(2)=4.512,P<0.05).Conclusion For children with acute appendicitis,the application of transumbilical single-port laparoscopic appendectomy can shorten the postoperative activity time,promote postoperative rehabilitation,and has less surgical trauma,which can reduce the level of inflammatory response and reduce complications.

关 键 词：经脐单孔腹腔镜 阑尾切除术 小儿 急性阑尾炎 炎性反应 

分 类 号：R65[医药卫生—外科学]