摘要
目的:比较腹腔镜阑尾切除残端荷包包埋术与开腹手术治疗急性化脓性阑尾炎患儿的效果。方法:选取2020年2月至2021年9月该院收治82例急性化脓性阑尾炎患儿进行前瞻性研究,按随机数字表法将其分为研究组与对照组各41例。对照组采用开腹手术治疗,研究组采用腹腔镜阑尾切除残端荷包包埋术治疗,比较两组手术相关指标水平、手术前后T细胞亚群指标水平、炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平和并发症发生率。结果:研究组手术时间、术后首次排气时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后1 d,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均低于术前,但研究组高于对照组,两组CD8^(+)水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后1 d,两组CRP、IL-6、TNF-α水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜阑尾切除残端荷包包埋术治疗急性化脓性阑尾炎患儿可缩短手术相关指标水平,改善T细胞亚群指标水平,降低炎性因子水平和并发生发生率,效果优于开腹手术治疗。
Objective:To compare effects of laparoscopic appendectomy stump pocket embedding and laparotomy in treatment of children with acute suppurative appendicitis.Methods:A prospective study was conducted on 82 children with acute suppurative appendicitis admitted to this hospital from February 2020 to September 2021.They were divided into study group and control group according to the random number table method,41 cases in each.The control group was treated with laparotomy,while the study group was treated with laparoscopic appendectomy stump pocket embedding.The levels of surgery-related indicators and the T cell subsets before and after the surgery,the inflammatory factor levels[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and the incidence of complications were compared between the two groups.Results:The operation time,the postoperative first exhaust time and the hospitalization time of the study group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).1 day after the surgery,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were lower than those before the surgery,but those in the study group were higher than those in the control group;the levels of CD8^(+)in the two groups were higher than those before the surgery,but that in the study group was lower than that in the control group and the differences were statistically significant(P<0.05).1 day after the surgery,the levels of CRP,IL-6 and TNF-αin the two groups were lower than those before the surgery,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusions:Laparoscopic appendectomy stump pocket embedding in the treatment of the children with acute suppurative appendicitis can shorten the levels of surgical related indicators,improve the levels of T cell subsets,reduce the levels of inflammatory factors and the incidence of complications.Moreover,it is superior to laparotomy.
作者
孙忠博
SUN Zhongbo(Pediatric Surgery of the Central Hospital of Jiamusi City,Jiamusi 154002 Heilongjiang,China)
出处
《中国民康医学》
2023年第12期132-134,138,共4页
Medical Journal of Chinese People’s Health
关键词
腹腔镜
阑尾切除残端荷包包埋术
患儿
急性化脓性阑尾炎
T细胞亚群
炎性因子
并发症
Laparoscopic
Appendectomy stump pocket embedding
Children
Acute suppurative appendicitis
T cell subset
Inflammatory factor
Complication
