目的研究微创手术治疗急性化脓性阑尾炎(APA)的临床效果及对血清细胞因子的影响.方法选取2020年1月-2022年12月我院收治的62例APA患者,经随机数字表法分为观察组和对照组,各31例.对照组行传统开腹手术治疗,观察组行腹腔镜微创手术治疗,比较两组手术指标[手术时间、术中出血量、术后6 h视觉模拟评分(VAS)、术后住院时间]、血清细胞因子[肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)、C反应蛋白(CRP)]、免疫指标[白细胞(WBC)、中性粒细胞(NEUT)]、手术并发症.结果 观察组手术时间、术后住院时间均短于对照组,术中出血量少于对照组、术后6 h VAS评分低于对照组(P＜0.05).两组术后TNF-α、IL-8、CRP水平均低于术前,且观察组低于对照组(P＜0.05).两组术后 WBC、NEUT指标低于术前,但观察组高于对照组(P＜0.05).观察组手术并发症发生率低于对照组(P＜0.05).结论 腹腔镜微创手术治疗APA具有手术时间短、出血少、术后疼痛轻、恢复快的优势,可有效下调患者血清细胞因子水平,发挥免疫保护作用,降低并发症发生风险.
Clinical Effect of Minimally Invasive Surgery in the Treatment of Acute Suppurative Appendicitis and its Effect on Serum Cytokines
Objective To study the clinical effect of minimally invasive surgery in the treatment of acute suppurative appendicitis(APA)and its effect on serum cytokines.Methods A total of 62 patients with APA admitted to our hospital from January 2020 to December 2022 were selected and divided into observation group and control group by random number table method,with 31 patients in each group.The control group was treated with traditional open surgery,and the observation group was treated with laparoscopic minimally invasive surgery.The surgery indexes[operation time,intraoperative blood loss,visual analogue scale(VAS)at 6 h after operation,postoperative hospital stay],serum cytokines[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),C-reactive protein(CRP)],immune indexes[white blood cell(WBC),neutrophil(NEUT)],and surgical complications were compared between the two groups.Results The operation time and postoperative hospital stay in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the VAS score at 6 h after operation was lower than that in the control group(P＜0.05).The levels of TNF-α,IL-8 and CRP in the two groups after operation were lower than those before operation,and those in the observation group were lower than the control group(P＜0.05).The WBC and NEUT indexes of the two groups after operation were lower than those before operation,but the observation group was higher than the control group(P＜0.05).The incidence of surgical complications in the observation group was lower than that in the control group(P＜0.05).Conclusion Laparoscopic minimally invasive surgery for APA has the advantages of short operation time,less bleeding,mild postoperative pain and rapid recovery,and can effectively down-regulate the serum cytokine levels of patients,play an immune protective role,and reduce the risk of complications.
Acute suppurative appendicitisLaparoscopic minimally invasive surgeryCytokinesImmune function
万方数据
维普
