腹腔镜手术治疗急性阑尾炎的临床疗效及对血清PCT和CRP水平的影响

Clinical Effect of Laparoscopic Surgery in Treatment of Acute Appendicitis and Its Impact on Serum PCT and CRP

目的:探讨腹腔镜手术治疗急性阑尾炎的临床疗效以及对患者血清降钙素原(PCT)和C反应蛋白(CRP)水平的影响。方法:选择2014年9月至2015年9月期间我院收治的急性阑尾炎患者80例为研究对象,采用随机数字表法将患者分为对照组(n=40)和观察组(n=40),观察组行腹腔镜手术治疗,对照组行开腹手术治疗,对比两组患者的疗效、并发症、围手术期外周血PCT、CRP的变化情况。结果:观察组患者术中出血量、术后首次肛门排气时间以及住院时间均明显少于对照组(P<0.05);观察组患者术后总并发症发生率明显低于对照组(P<0.05);术后第1 d,两组患者的血清PCT、CRP水平相比术前均有明显升高(P<0.05);术后第3 d,观察组血清PCT、CRP水平则与术前无明显差异(P>0.05),而对照组则仍明显高于术前水平(P<0.05);术后第5 d,观察组血清PCT、CRP水平明显低于术前(P<0.05),而对照组与术前相比无统计学意义(P>0.05)。观察组术后第1、3、5 d的血清PCT、CRP水平均明显低于对照组(P<0.05)。结论:相比开腹手术,腹腔镜手术治疗急性阑尾炎患者疗效显著,能有效控制血清PCT、CRP水平,有利患者及早康复。

Objective： To investigate the clinical effect of laparoscopic surgery in treatment of acute appendicitis and its impact on serum procalcitonin（PCT） and C reactive protein（CRP） levels. Methods： A total of 80 patients with acute appendicitis who were treated in our hospital from September 2014 to September 2015, they were divided into control group（n=40） and observation group（n=40） according to the random number table method, the observation group was underwent laparoscopic surgery, and the control group was underwent open surgery, then compared the effect, the complication, serum PCT and CRP during perioperative period in two groups. Results：The intraoperative bleeding volume, the first postoperative anus exhaust time and length of stay in observation group were significantly less than control group（P〈0.05）. The total postoperative complication rate in observation group was significantly lower than control group（P〈0.05）; The serum PCT and CRP levels in two groups 1d day after surgery were significantly increased than before surgery（P〈0.05）, 3 d day after surgery in observation group had no different than before surgery（P〉0.05）, while the control group were still higher than before surgery（P〈0.05）; 5 d day after surgery in observation group were lower than before surgery（P〈0.05）, while the control group had no different than before surgery（P〉0.05）. Conclusion： Compared to open surgery, the laparoscopic surgery has obvious effect in in treatment of acute appendicitis, which can control the serum PCT and CRP levels better, and is help for the early recovery of patients.