摘要
目的探究腹壁吊线辅助经脐单孔腹腔镜阑尾切除术(TUSPLA)在急性阑尾炎(AA)患者治疗中的应用价值。方法根据手术方法不同将2019年12月至2021年1月于内黄县中医院治疗的90例AA患者分为试验组、常规组,每组45例。试验组予以腹壁吊线辅助TUSPLA,常规组予以传统腔镜阑尾切除术(LA)。对比两组围手术期指标、术前及术后各时间疼痛程度(VAS)、血管内皮功能、炎症介质水平及并发症情况。结果试验组手术时间、术中出血量与常规组对比,差异无统计学意义(P>0.05),胃肠功能恢复时间、卧床时间及住院时间较常规组短,差异有统计学意义(P<0.05);术后1 d、术后3 d两组VAS评分降低,且试验组较低(P<0.05);术后1 d、术后3 d两组一氧化氮(NO)、内皮素(ET)水平降低,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);术后1 d、术后3 d两组白介素(IL-6、IL-8)、敏C反应蛋白(Hs-CRP)水平升高,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);试验组并发症发生率(8.89%)与常规组(15.56%)对比,差异无统计学意义(P>0.05)。结论腹壁吊线辅助TUSPLA与LA治疗AA患者引起的炎症反应及对血管内皮功能造成的损伤相当,但TUSPLA能优化手术情况,能减轻术后疼痛,胃肠功能恢复较快,有助于改善预后。
Objective To explore the value of laparoscopic appendectomy through umbilical single port assisted by abdominal wall sling in the treatment of acute appendicitis(AA).Methods According to different surgical methods,90 patients with AA treated in Neihuang County Hospital of traditional Chinese medicine from December 2019 to January 2021 were divided into experimental group and routine group,with 45 cases in each group.The experimental group was treated with TUSPLA assisted by abdominal wall sling,and the conventional group was treated with traditional endoscopic appendectomy(LA).The perioperative indexes,preoperative and postoperative pain severity(VAS),vascular endothelial function,inflammatory mediators and complications were compared between the two groups.Results There was no significant difference in operation time and intraoperative blood loss between the experimental group and the routine group(P>0.05).The recovery time of gastrointestinal function,bed time and hospitalization time in the experimental group were shorter than those in the routine group(P<0.05);The VAS score of the two groups decreased 1 day and 3 days after operation,and the VAS score of the experimental group was lower(P<0.05);The levels of nitric oxide(NO)and endothelin(ET)in the two groups decreased 1 and 3 days after operation(P<0.05),but there was no significant difference between the two groups(P>0.05);The levels of interleukin(IL-6,IL-8)and sensitive C-reactive protein(hs-CRP)in the two groups increased 1 day and 3 days after operation,the difference was statistically significant(P<0.05),but there was no significant difference between the two groups(P>0.05);The incidence of complications in the experimental group was 8.89%,compared with 15.56%in the routine group,and there was no significant difference(P>0.05).Conclusion The inflammatory reaction and vascular endothelial function damage caused by TUSPLA assisted by abdominal wall sling are equivalent to that caused by LA in the treatment of AA patients,but TUSPLA can optimize the operation,reduce postoperative pain,and recover gastrointestinal function quickly,which is helpful to improve the prognosis.
作者
赵彦军
王连波
ZHAO Yanjun;WANG Lianbo(Department of General Surgery,Neihuang Hospital of Traditional Chinese Medicine,Anyang Henan 456300,China)
出处
《临床研究》
2022年第7期70-73,共4页
Clinical Research
关键词
腹壁吊线
腹腔镜阑尾切除术
急性阑尾炎
血管内皮功能
炎性反应
abdominal wall sling
laparoscopic appendectomy
acute appendicitis
vascular endothelial function
inflammatory reaction
作者简介
赵彦军(1968-),男,汉族,河南内黄人,副主任医师,本科。研究方向:微创治疗急性阑尾炎,胆囊炎方向。
