摘要
目的:比较腹腔镜手术与常规开腹手术应用于小儿阑尾炎的临床价值。方法:抽取2018年1月至2020年12月河南省儿童医院收治的小儿阑尾炎患儿68例,按照随机数字表法分为对照组和研究组,每组34例。对照组采用常规开腹手术治疗,研究组采用腹腔镜手术治疗。比较两组围术期指标(手术时间、术中出血量、肛门排气时间、住院时间)、血清炎症因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平、视觉模拟评分法(VAS)评分、免疫功能[T淋巴细胞(CD3^(+)、CD4^(+))]及并发症发生率。结果:研究组手术时间、肛门排气时间、住院时间短于对照组,且术中出血量少于对照组(P<0.05)。术前,两组血清炎症因子水平比较差异未见统计学意义(P>0.05);术后3 d,研究组CRP、TNF-α、IL-6水平低于对照组(P<0.05)。术前,两组VAS评分比较差异未见统计学意义(P>0.05);术后3 d,研究组VAS评分低于对照组(P<0.05)。术前,两组CD3^(+)、CD4^(+)水平比较差异未见统计学意义(P>0.05);术后3 d,研究组CD3^(+)、CD4^(+)水平高于对照组(P<0.05)。研究组并发症发生率(2.94%,1/34)低于对照组(23.53%,8/34),P<0.05。结论:与常规开腹手术相比,腹腔镜手术治疗小儿阑尾炎的效果显著,能降低术中出血量,缩短手术时间和住院时间,有效缓解机体炎症和疼痛症状,提高患儿免疫功能,降低并发症发生率。
Objective To compare the clinical value of laparoscopic surgery and conventional laparotomy in the treatment of pediatric appendicitis.Methods A total of 68 children with appendicitis treated in Henan Children's Hospital from January 2018 to December 2020 were selected,and they were divided into control group and study group according to random number table method,with 34 cases in each group.The control group received conventional laparotomy,and the study group received laparoscopic surgery.The perioperative indicators(operation time,intraoperative blood loss,anal exhaust time,length of hospital stay),levels of serum inflammatory factors,including tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6),visual analogue scale(VAS)score,immune function assessed by T lymphocytes,including cluster of differentiation 3*(CD3^(+))and cluster of differentiation 4^(+)(CD4^(+)),and incidence of complication of the two groups were compared.Results Compared with the control group,the study group had shorter operation time,shorter anal exhaust time,shorter hospital stay,and less intraoperative blood loss(P<0.05).There was no significant difference in levels of inflammatory factors between the two groups before treatment(P>0.05).The levels of CRP,TNF-αand IL-6 in the study group were lower than those in the control group 3 days after surgery(P<0.05).There was no significant difference in VAS score between the two groups before treatment(P>0.05);while VAS score of the study group was lower than that of the control group 3 days after surgery(P<0.05).There was no significant difference in levels of CD3^(+)and CD4^(+)between the two groups before treatment(P>0.05);the levels of CD3*and CD4*in the study group were higher than those in the control group 3 days after surgery(P<0.05).The incidence of complication of the study group(2.94%,1/34)was lower than that of the control group(23.53%,8/34),P<0.05.Conclusions Compared with conventional laparotomy,laparoscopic surgery is effective in the treatment of pediatric appendicitis.It can reduce intraoperative blood loss,shorten operation time and hospital stay,effectively relieve inflammation and pain symptoms,improve immune function of children,and reduce the incidence of complications.
作者
侯栋亮
李朋飞
冯全得
Hou Dongliang;Li Pengfei;Feng Quande(WardⅡ,Department of General Surgery,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou 450018,China)
出处
《中国实用医刊》
2023年第9期41-44,共4页
Chinese Journal of Practical Medicine
关键词
阑尾炎
小儿
腹腔镜手术
开腹手术
Appendicitis
Children
Laparoscopic surgery
Laparotomy
作者简介
通信作者:侯栋亮,Email:hdl19860713@163.com。
