Clinical study of laparoscopy based on intraoperative virtual remote guidance in treating acute appendicitis in Gongshan and other primary hospitals in Yunnan Province
Objective To explore the clinical efficacy of laparoscopy[laparoscopic appendectomy(LA)]based on intraoperative virtual remote guidance in treating acute appendicitis in Gongshan and other primary hospitals in Yunnan Province.Methods 192 patients with acute appendicitis were divided into a control group and an observation group according to random number table method,each with 96 cases.The control group received LA treatment without the support of virtual reality technology(VRT)and remote surgical consultation(ROC)technology,while the observation group received LA treatment with the support of VRT and ROC technology.Comparison was made on indexes related to surgery,ratio of conversion to laparotomy,visual analogue scale(VAS)score of postoperative incision pain,gastrointestinal quality of life index(GLQI)score and inflammatory index[C-reactive protein(CRP),white blood cell count(WBC)]levels before and after operation,and postoperative complications between the two groups.Results The observation group had significantly less intraoperative blood loss of(15.36±2.17)ml than(21.47±3.28)ml in the control group;the operation time in the observation group was(42.44±6.65)min and the first postoperative exhaust time was(22.49±4.35)h,which were significantly shorter than(50.95±7.12)min and(28.67±5.01)h in the control group(P<0.05).The ratio of conversion to laparotomy in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).The incision VAS scores of the observation group at 12,24 and 36 h after surgery were(4.11±1.03),(3.36±0.85)and(2.41±0.59)points,which were significantly lower than(5.68±1.10),(4.52±0.97)and(3.38±0.78)points of the control group at the same period(P<0.05).GLQI scores in both groups were significantly increased 4 weeks after surgery,and the observation group had significantly higher GLQI score of(123.85±13.21)points than(117.63±15.44)points in the control group(P<0.05).Compared with before surgery,the levels of CRP and WBC in whole blood in both groups were significantly decreased 24 h after surgery;at 24 h after surgery,CRP and WBC in whole blood were(36.22±4.95)mg/L and WBC(10.04±2.41)×109/L in the observation group,which were significantly lower than(51.83±5.23)mg/L and(13.72±3.08)×109/L in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Laparoscopy based on intraoperative virtual remote guidance is beneficial to reduce intraoperative bleeding in patients with acute appendicitis,improve surgical efficiency,promote gastrointestinal function recovery,reduce postoperative pain and inflammatory response,and lower the risk of complications.The surgical effect is satisfactory.It provides a scientific and effective scheme for improving the treatment level of acute appendicitis in Gongshan and other primary hospitals in Yunnan Province.
Acute appendicitisVirtual realityReal time guidanceLaparoscopyAppendectomyInflammatory reaction
万方数据
维普
