两种阑尾插管方法在内镜逆行阑尾炎治疗术中的应用比较  

Comparison of two appendiceal intubation methods in endoscopic retrograde appendicitis treatment

作　　者：卢磊[1] 毕小刚[1] 张艳[1] 田丰[1] Lu Lei;Bi Xiaogang;Zhang Yan;Tian Feng(Department of Gastroenterology,Zigong Fourth People’s Hospital,Zigong Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院消化内科,四川自贡643000

出　　处：《遵义医科大学学报》2024年第11期1088-1092,共5页Journal of Zunyi Medical University

摘　　要：目的两种阑尾插管方法在内镜逆行阑尾炎治疗术中的应用比较。方法100例急性非复杂性阑尾炎患者随机分为弓刀组(50例)与导管组(50例),弓刀组采用乳头括约肌切开刀配合导丝阑尾插管,辅助内镜逆行阑尾炎治疗术,导管组采用造影导管配合导丝阑尾插管,辅助内镜逆行阑尾炎治疗术。比较两组阑尾插管成功率、阑尾插管时间、手术时间、住院天数、腹痛消失时间、麦氏点压痛消失时间、白细胞复常时间、中性粒细胞百分比复常时间、阑尾炎复发率及手术并发症发生率。结果弓刀组阑尾插管时间短于导管组阑尾插管时间[6.00(4.15~7.45)min vs 8.65(6.08~11.23)min,P<0.001],弓刀组手术时间短于导管组手术时间[(47.51±10.70)min vs(55.96±12.21)min,P<0.001]。弓刀组阑尾插管成功率100%高于导管组阑尾插管成功率88%(P<0.05)。两组住院天数、腹痛消失时间、麦氏点压痛消失时间、白细胞复常时间、中性粒细胞百分比复常时间、阑尾炎复发率及手术并发症发生率比较无差异。结论乳头括约肌切开刀辅助阑尾插管能提高内镜逆行阑尾炎治疗术阑尾插管成功率、缩短阑尾插管时间及手术时间,不增加手术并发症,安全有效,值得临床推广。Objective To compare the application of two different appendiceal intubation methods in endoscopic retrograde appendicitis treatment.Methods 100 patients with acute uncomplicated appendicitis were randomly divided into an arched knife group(50 cases)and a catheter group(50 cases).The arched knife group was treated with guide wire combined with sphincterotomy knife for appendiceal intubation and assisted endoscopic retrograde appendicitis treatment,while the catheter group was treated with guide wire combined with angiography catheter for appendiceal intubation and assisted endoscopic retrograde appendicitis treatment.The success rate of appendiceal intubation,appendiceal intubation time,operation time,hospitalization time,disappearance time of abdominal pain,disappearance time of McBurney’s point tenderness,time of leukocyte normalization,time of neutrophil percentage normalization,recurrence rate of appendicitis,and incidence of surgical complications were compared between the two groups.Results The appendiceal intubation time of 6.00(4.15-7.45)minutes in the arched knife group was shorter than that of 8.65(6.08-11.23)minutes in the catheter group(P<0.001).The operation time of the arched knife group was(47.51±10.70)minutes shorter than that of the catheter group,which was(55.96±12.21)minutes(P<0.001).The success rate of appendiceal intubation in the arched knife group was 100%higher than that in the catheter group,which was 88%(P<0.05).There was no statistically significant difference between the two groups in hospitalization time,time of disappearance of abdominal pain,time of disappearance of McBurney’s point tenderness,time of normalization of white blood cells,time of normalization of neutrophil percentage,recurrence rate of appendicitis,and incidence of surgical complications.Conclusion The sphincterotomy knife assisted endoscopic retrograde appendicitis treatment can improve the success rate of appendiceal intubation,shorten the duration of appendiceal intubation and operation,and does not increase

关 键 词：阑尾炎 急性非复杂性阑尾炎 内镜逆行阑尾炎治疗术 乳头括约肌切开刀 

分 类 号：R656.8[医药卫生—外科学]