摘要
目的分析腹腔镜阑尾切除术对化脓性阑尾炎并发2型糖尿病患者的临床效果。方法选取2013年1月-2014年12月于该院手术治疗的68例急性化脓性阑尾炎合并2型糖尿病患者为研究对象,采用随机数字表法将患者随机分为腹腔镜组和开腹组,每组34例。比较两组患者的术中情况、术后康复情况及术前10 min(T1)、手术开始后30 min(T2)及手术结束后30 min(T3)的血糖、胰岛素及胰岛素抵抗指数的变化。结果腹腔镜组患者较开腹组手术时间短,手术切口小,术中出血量少,差异均有统计学意义(P<0.05)。与开腹组患者比较,腹腔镜组患者下床活动时间、肛门排气时间、术后引流时间、术后抗生素时间及术后住院时间明显缩短(P<0.05);腹腔镜组术患者后并发症发生率为2.94%明显低于开腹组患者17.65%(χ2=3.98,P<0.05)。两组患者在T1和T3时间点血糖、胰岛素及胰岛素抵抗指数差异无统计学意义(P>0.05)。在T2时间点,开腹组患者的胰岛素、血糖及胰岛素抵抗指数分别为(17.6±1.4)m U/L、(9.8±1.3)mmol/L和(7.6±0.4),明显高于腹腔镜组的(15.2±0.9)m U/L、(8.7±1.4)mmol/L和(5.4±0.3)。结论采用腹腔镜阑尾切除术治疗急性化脓性阑尾炎合并2型糖尿病患者具有创伤小、恢复快、并发症少等优点,且对患者的血糖、胰岛素水平及胰岛素抵抗的影响小。
【Objective】To analyze the effect of laparoscopic appendectomy on clinical effect in patients with suppurative appendicitis combined with type 2 diabetes meilitus. 【Methods】68 patients with suppurative appendicitis combined with type 2 diabetes meilitus, from January 2013 to December 2014 in our hospital treated with surgery,were randomly divided into laparoscopic group and open surgery group by random number table, 34 cases in each group. The intraoperative conditions, postoperative rehabilitation, glucose, insulin and insulin resistance index at preoperative minute 10（T1）, intraoperative minute 30（T2） and postoperative minute 30（T3） were analyzed in the two groups. 【Results】Compared with the open surgery group, laparoscopic surgery group had much shorter operation time, smaller incision and less blood loss, the differences were statistically significant（P〈0.05）. Ambulation time,anal exhaust time, postoperative drainage time, postoperative antibiotic time and postoperative hospital stay in laparoscopic surgery group were significantly shorter than the open surgery group（P〈0.05）. The incidence of postoperative complications in laparoscopic surgery group（2.94 %） was lower than laparotomy patients 17.65%（χ^2= 3.98,P〈0.05）. At T1 and T3, blood glucose, insulin and resistance index in the two groups were not significantly different（P〉0.05）. At T2, the blood glucose, insulin and resistance index of laparotomy group were（17.6 ± 1.4） m U/L,（9.8 ±1.3） mmol/L,（7.6 ± 0.4）, which were significantly higher than the laparoscopic group（15.2 ± 0.9） m U/L,（8.7 ± 1.4）mmol/L,（5.4 ± 0.3）.【Conclusion】Laparoscopic appendectomy for patients with suppurative appendicitis combined with diabetes meilitus has significant advantages over open appendectomy with less trauma, faster recovery, and lower incidence of complications. It has less impact on patients＇ blood glucose, insulin and insulin resistance.
出处
《中国内镜杂志》
北大核心
2015年第12期1298-1301,共4页
China Journal of Endoscopy
关键词
化脓性阑尾炎
2型糖尿病
腹腔镜
suppurative appendicitis
type 2 diabetes
laparoscopy
