腹腔镜下系膜剥离法阑尾切除术治疗急性阑尾炎的效果  

Effect of Laparoscopic Mesangial Stripping Appendectomy in the Treatment of Acute Appendicitis

作　　者：张志祥 王奇维 ZHANG Zhixiang;WANG Qiwei(Department of General Surgery,Guiyang Baiyun Friendship Hospital,Guiyang 550014,China;不详)

机构地区：[1]贵阳白云友爱医院普外科,贵州贵阳550014

出　　处：《中国医学创新》2025年第12期158-161,共4页Medical Innovation of China

摘　　要：目的:探讨腹腔镜下系膜剥离法阑尾切除术在急性阑尾炎(AA)患者中的治疗效果。方法:回顾性分析2022年3月—2024年3月贵阳白云友爱医院收治的80例AA患者的临床资料,按不同手术方法分为两组,各40例。对照组采取腹腔镜阑尾切除术(LA),观察组采取腹腔镜下系膜剥离法阑尾切除术。对比两组围手术期指标、炎症指标、并发症发生率。结果:观察组手术时间[(51.67±5.25)min]长于对照组[(42.33±4.17)min],住院时间[(3.24±0.33)d]短于对照组[(4.02±0.46)d],术后排气时间[(18.35±1.43)h]、排便时间[(23.44±2.36)h]、肠鸣音恢复时间[(11.94±1.36)h]、下床活动时间[(10.54±1.22)h]均早于对照组[(21.54±2.24)h、(28.65±3.22)h、(14.77±1.45)h、(12.35±1.27)h],术中出血量[(21.34±2.22)mL]少于对照组[(25.08±2.41)mL],术后24 h视觉模拟评分法(VAS)评分[(2.86±0.32)分]低于对照组[(3.29±0.42)分],差异均有统计学意义(P<0.05)。术后24 h,观察组C反应蛋白(CRP)[(14.89±1.23)mg/L]、白介素-6(IL-6)[(62.64±5.45)pg/mL]、肿瘤坏死因子-α(TNF-α)[(10.94±1.23)μg/L]、白细胞计数(WBC)[(14.36±1.35)×10^(9)/L]均低于对照组[(16.05±1.34)mg/L、(73.15±6.02)pg/mL、(13.10±1.26)μg/L、(16.48±2.33)×10^(9)/L],差异均有统计学意义(P<0.05)。观察组并发症发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论:腔镜下系膜剥离法阑尾切除术用于AA的治疗中,患者术后疼痛、炎症反应轻,并发症少,且术后恢复快。Objective:To investigate the therapeutic effect of laparoscopic mesangial stripping appendectomy in patients with acute appendicitis(AA).Method:The clinical data of 80 AA patients admitted to Guiyang Baiyun Friendship Hospital from March 2022 to March 2024 were retrospectively analyzed and divided into two groups according to different surgical methods,with 40 cases in each group.The control group underwent laparoscopic appendectomy(LA),and the observation group underwent laparoscopic mesangial stripping appendectomy.Perioperative indexes,inflammatory indexes and complication rate were compared between the two groups.Result:The operation time[(51.67±5.25)min]in the observation group was longer than(42.33±4.17)min in the control group,hospital stay[(3.24±0.33)d]in the observation group was shorter than(4.02±0.46)d in the control group,the postoperative exhaust time[(18.35±1.43)h],defecation time[(23.44±2.36)h],bowel sound recovery time[(11.94±1.36)h]and getting out of bed time[(10.54±1.22)h]were earlier than(21.54±2.24)h,(28.65±3.22)h,(14.77±1.45)h,(12.35±1.27)h in the control group,the intraoperative blood loss[(21.34±2.22)mL]was less than(25.08±2.41)mL in the control group,and 24 h postoperative visual analogue scale(VAS)score[(2.86±0.32)scores]was lower than(3.29±0.42)scores in the control group,the differences were statistically significant(P<0.05).24 hours after surgery,C reactive protein(CRP)[(14.89±1.23)mg/L],interleukin-6(IL-6)[(62.64±5.45)pg/mL],tumor necrosis factor-α(TNF-α)[(10.94±1.23)μg/L]and white blood cell count(WBC)[(14.36±1.35)×10^(9)/L]of observation group were lower than(16.05±1.34)mg/L,(73.15±6.02)pg/mL,(13.10±1.26)μg/L,(16.48±2.33)×10^(9)/L of control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 5.00%,which was lower than 20.00%in the control group,the difference was statistically significant(P<0.05).Conclusion:Laparoscopic mesangial stripping appendectomy for the treatment of AA,the pati

关 键 词：急性阑尾炎 腹腔镜下系膜剥离法阑尾切除术 围手术期 炎症指标 并发症 

分 类 号：R656.8[医药卫生—外科学]