内镜下阑尾腔冲洗术在急性单纯性阑尾炎中的应用

Clinical application of endoscopic appendical cavity irrigation to acute simple appendicitis

目的探讨内镜下阑尾腔冲洗术治疗急性单纯性阑尾炎的可行性及效果。方法 60例符合纳入标准的急性单纯性阑尾炎患者按随机原则分为内镜下治疗30例(观察组),外科传统腹腔镜治疗30例(对照组),对比分析两组术后腹痛改善时间、术后进食时间、下床活动时间、术后并发症、住院天数、住院费用等情况。结果观察组腹痛改善时间(1.06±0.10)d,术后进食时间(3.86±0.38)h,术后下床活动时间(3.00±0.55)h,住院费用(5 341.3±706.3)元;对照组腹痛改善时间为(1.54±0.04)d,术后进食时间(24.00±0.01)h,术后下床活动时间(14.12±1.29)h,住院费用(9 148.10±403.10)元,两组各项指标比较,差异均有统计学意义(P<0.01);观察组住院天数为(6.64±0.70)d,对照组为(7.12±0.36)h,观察组及对照组均未发生出血、穿孔、感染等并发症。随访1年,观察组复发率为3.33%(1/30),对照组未见复发。结论内镜下阑尾腔冲洗术治疗急性单纯性阑尾炎安全有效,具有操作简便、创伤小、出血少、无手术瘢痕等优点,能较快改善症状,提高患者的生活质量,减少住院费用。

Objective To investigate the feasibility and efficacy of endoscopic appendical cavity irrigation in the treatment of acute simple appendicitis. Methods Sixty patients with acute simple appendicitis who met the inclusion criteria were randomly divided into the patients treated with endoscopic therapy group（ n = 30,observation group） or with traditional laparoscopic surgery（ n = 30,control group）. The durations of abdominal pain improvement and postoperative feeding,the ambulation time,postoperative complications,hospital stay and hospitalization expense were assessed and compared between the two groups. Results The durations of abdominal pain improvement and postoperative feeding,ambulation time and hospitalization expense in the observation group were（ 1. 06 ± 0. 10） d,（ 3. 86 ± 0. 38） h,（ 3. 00 ± 0. 55） h and（ 5 341. 3 ±706. 3） yuan. The durations of abdominal pain improvement and postoperative feeding,ambulation time and hospitalization expense in the control group were（ 1. 54 ± 0. 04） d,（ 24. 00 ± 0. 01） h,（ 14. 12 ± 1. 29） h and（ 9 148. 10 ± 403. 10）） yuan. And there were significant differences in the indexes above between the two groups（ P 0. 01）. The hospital stay of the observation group and control group were（ 6. 64 ± 0. 70） d and（ 7. 12 ± 0. 36） d respectively. No postoperative complications including bleeding,perforation and infection occurred in both groups. During the follow-up of 1 years,the recurrence rate of the observation group was3. 33%（ 1/30）,but no recurrence was observed in the control group. Conclusion Endoscopic appendical cavity irrigation for acute simple appendicitis is safe and effective,and has the advantages of simple operation,less trauma,less bleeding loss and being scarless,can rapidly improve the symptoms and the quality of life of patients,and can reduce the hospitalization costs.