摘要
目的 对急腹症患者,腹腔镜微创手术治疗的临床价值和安全性进行探讨研究.方法 选取2022年3月至2024年2月福州市晋安区医院收治的82例急腹症患者,采用随机数字表法分为腹腔镜组(观察组,41例)和常规开腹组(对照组,41例).比较两组患者手术及预后相关临床指标、临床疗效、炎症因子水平、应激反应相关激素水平、并发症发生情况.结果 观察组手术时间、术中出血量、首次下床活动时间、术后排气时间、切口长度、住院时间均显著短于对照组(P<0.001).观察组临床总有效率为97.56％(40/41),高于对照组的78.05％(32/41),差异有统计学意义(P=0.007).手术前,两组患者炎症因子C反应蛋白、肿瘤坏死因子、白细胞介素-6,应激反应相关激素肾上腺素、去甲肾上腺素、皮质醇水平均无显著差异(P>0.05);手术后,两组患者以上炎症因子和应激反应相关激素水平均升高,且观察组C反应蛋白、肿瘤坏死因子、白细胞介素-6、肾上腺素、皮质醇水平显著低于对照组患者(P<0.001);观察组患者去甲肾上腺素显著低于对照组(P=0.010).观察并发症发生率(4.88％)显著低于对照组(29.27％),差异有统计学意义(P<0.05).结论 对于急腹症患者,腹腔镜微创手术可显著缩短患者术后恢复时间,提高临床疗效,调节炎症因子,降低应激反应,减少并发症的发生风险.
Abstract
Objective To explore and study the clinical value and safety of laparoscopic minimally invasive surgery for patients with acute abdomen. Methods 82 patients with acute abdomen admitted to Jin'an District Hospital in Fuzhou City from March 2022 to February 2024 were selected and randomly divided into a laparo-scopic group (observation group,41 cases) and a conventional open surgery group (control group,41 cases) using a random number table method. Compare the clinical indicators related to surgery and prognosis,clinical efficacy,levels of inflammatory factors,levels of stress response related hormones,and incidence of complications between two groups of patients. Results The observation group had significantly shorter surgical time,intraoperative blood loss,first mobilization time,postoperative exhaust time,incision length,and hospitalization time compared to the control group (P<0.001). The total clinical effective rate of the observation group was 97.56％ (40/41),which was higher than the 78.05％ (32/41) of the control group,and the difference was statistically significant (P=0.007). Before surgery,there was no significant difference in the levels of inflammatory factor C-reactive protein,tumor necrosis factor,interleukin-6,stress response related hormones adrenaline,norepinephrine,and cortisol between the two groups of patients (P>0.05);After surgery,the levels of inflammatory factors and stress-related hormones increased in both groups of patients,and the levels of C-reactive protein,tumor necrosis factor,interleukin-6,adrenaline,and cortisol in the observation group were significantly lower than those in the control group (P<0.001);The observation group had significantly lower levels of norepinephrine than the control group (P=0.010). The inci-dence of complications observed (4.88％) was significantly lower than that of the control group (29.27％),and the difference was statistically significant (P<0.05). Conclusion For patients with acute abdomen,laparoscopic min-imally invasive surgery can significantly shorten the postoperative recovery time,improve clinical efficacy,regulate inflammatory factors,reduce stress response,and reduce the risk of complications.
维普
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