Analysis of the effect of open and laparoscopic appendectomy in the treatment of patients with perforated gangrenous appendicitis
Objective To explore the effect of open and laparoscopic appendectomy in the treatment of patients with perforated gangrenous appendicitis.Methods 84 patients with perforated gangrenous appendicitis were randomly divided into an observation group and a control group,with 42 cases in each group.The control group was treated with conventional open surgery,and the observation group was treated with laparoscopic appendectomy.The surgical indicators,complications,inflammation and stress response indicators and World Health Organization quality of life-100(WHOQOL-100)score of the two groups were compared.Results The observation group had operation time of(58.67±6.20)min,postoperative exhaust time of(25.16±5.42)h,off-bed ambulation time of(8.31±2.04)h,and hospitalization time of(6.21±1.68)d,which were all shorter than(71.35±8.48)min,(52.37±7.89)h,(24.84±4.03)h,and(12.57±3.03)d in the control group;the observation group has less intraoperative blood loss of(24.38±4.16)ml than(64.73±9.51)ml in the control group;the observation group had less visual analogue scale(VAS)score of(2.42±0.65)points at 1 d after surgery than(5.18±1.02)points in the control group(P<0.05).The complication rate of 4.76%in the observation group was lower than 23.81%in the control group(P<0.05).At 24 h after surgery,the observation group had procalcitonin(PCT)of(0.62±0.20)μg/L,C-reactive protein(CRP)of(22.91±4.35)mg/L,tumor necrosis factor-α(TNF-α)of(47.83±11.76)μg/L and cortisol(Cor)of(54.64±7.72)μg/dl,which were lower than(139±0.24)μg/L,(31.83±5.72)mg/L,(75.14±14.59)μg/L and(126.43±13.51)μg/dl in the control group(P<0.05).At 1 week after surgery,the scores in fields of physiology,independence,social relations,psychology and environment in the observation group were(4.03±0.22),(4.10±0.24),(4.14±0.23),(4.12±0.28)and(4.17±0.29)points,which were higher than(2.97±0.28),(3.01±0.27),(3.04±0.25),(2.95±0.24)and(3.06±0.25)points in the control group(P<0.05).Conclusion Laparoscopic appendectomy for perforated gangrenous appendicitis has a better effect,with mild postoperative inflammation and stress reaction,rapid recovery and low incidence of complications,which is helpful to improve the quality of life quickly and has positive clinical significance.
NETL
NSTL
万方数据
维普
