腹腔镜阑尾切除术与开腹阑尾切除术治疗根部穿孔性阑尾炎的效果比较  

Comparison on therapeutic effects of laparoscopic appendectomy and open appendectomy on root perforated appendicitis

作　　者：常存旭 Chang Cunxu(Department of General Surgery,the First People's Hospital of Xiangcheng,Xiangcheng 466200,China)

机构地区：[1]项城市第一人民医院普通外科,项城466200

出　　处：《中国实用医刊》2024年第23期58-61,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较根部穿孔性阑尾炎(PA)应用腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)治疗的效果。方法回顾性抽取2021年1月至2024年2月项城市第一人民医院收治的根部PA患者68例,按照手术方案不同分为OA组与LA组,每组34例;OA组采用OA治疗,LA组采用LA治疗。对比两组患者围术期指标、炎症因子、氧化应激指标、术后并发症。结果两组手术时间比较差异未见统计学意义(P>0.05),但LA组手术出血量、切口长度、术后各项恢复时间(首次下床活动、排气排便恢复、肠鸣音恢复、住院时间等)均低于OA组(P均<0.05);术前,两组炎症因子、氧化应激指标比较差异未见统计学意义(P>0.05),术后3 d,LA组白细胞介素-6、C反应蛋白、降钙素原、肿瘤坏死因子-α水平低于OA组,LA组氧化物歧化酶水平高于OA组,丙二酸水平低于OA组(P<0.05);LA组并发症发生率(5.88%,2/34)低于OA组(23.53%,8/34),P<0.05。结论相比OA治疗根部PA,LA治疗虽会延长手术时间,但可减少手术创伤,促进术后更快恢复,其并发症发生率更低,且在减轻术后炎症反应与氧化应激反应上的作用更好。ObjectiveTo compare the effect of laparoscopic appendectomy(LA)and open appendectomy(OA)in the treatment of root perforated appendicitis(PA).Methods Sixty-eight patients with root PA admitted to the First People’s Hospital of Xiangcheng from January 2021 to February 2024 were retrospectively selected,and they were divided into the OA group and the LA group according to surgical schemes,with 34 cases in each group.The OA group was treated by OA,and the LA group was treated by LA.The perioperative indexes,inflammatory factors,oxidative stress indexes and postoperative complications of the two groups were compared.Results There was no significant difference in operation duration between the two groups(P>0.05);but the intaroperative blood loss,incision length and postoperative recovery time(first getting out of bed,recovery of exhaust and defecation,recovery of bowel sounds,hospital stay)in the LA group were lower than those in the OA group(all P<0.05).Before operation,there was no significant difference in inflammatory factors and oxidative stress indexes between the two groups(P>0.05).Three days after treatment the LA group had lower levels of interleukin-6,C-reactive protein,procalcitonin and tumor necrosis factor-α,and had higher level of SOD,as well as lower level of malonic acid,compared with the OA group(P<0.05).The incidence of complications in the LA group(5.88%,2/34)was lower than that in the OA group(23.53%,8/34),P<0.05.Conclusions Compared with OA in the treatment of root PA,although LA treatment can prolong the operation duration,it can reduce the surgical trauma,promote the postoperative recovery faster and lower complication rate,moreover,has a better effect on reducing postoperative inflammation and oxidative stress reaction.

关 键 词：阑尾炎 穿孔 腹腔镜阑尾切除术 开腹阑尾切除术 术后恢复效果 

分 类 号：R65[医药卫生—外科学]