腹腔镜手术在减少穿孔性阑尾术后应激中的应用

Application of Laparoscopic Surgery in Reducing the Stress after the Perforated Appendicitis

目的对穿孔性阑尾患者采取腹腔镜手术对减少应激的效果进行分析。方法选取2017年2月—2018年2月该院收治的60例阑尾穿孔性患者作为研究对象,以随机的方式将患者分为对照组(n=30)和观察组(n=30),将传统开腹手术应用于对照组临床,观察组采用腹腔镜手术展开治疗,比较两组患者的治疗效果。结果观察组CRP(54.14±3.12)mg/L、外周血糖(4.61±2.31)mmol/L、住院时间(6.23±1.24)d优于对照组的CRP(76.42±3.24)mg/L、外周血糖(7.32±2.34)mmol/L、住院时间(10.12±1.14)d,差异有统计学意义(t=6.342、6.412、6.641,P<0.05);且观察组镇痛药物使用率10.0%与手术满意率86.6%优于对照组镇痛药物使用率43.3%与手术满意率60.0%,差异异有统计学意义(χ~2=8.241、9.201,P<0.05);另外,观察组患者并发症发生率(6.6%)低于对照组(23.3%),差异有统计学意义(t=8.341,P<0.05)。结论将腹腔镜手术应用于阑尾穿孔性患者临床治疗中具有重要意义,其能够有效减少术后应激反应,该手术操作具有的创伤小、并发症发生率低等优点能够提高治疗效果,有助于促进患者疾病的康复,因此,该方法值得在临床中推广应用。

Objective To analyze the application of laparoscopic surgery in reducing the stress after the perforated appendicitis. Methods 60 cases of patients with perforated appendicitis admitted and treated in our hospital from February 2017 to February 2018 were selected and randomly divided into two groups with 30 cases in each, the control group used the traditional laparotomy, while the observation group were treated with laparoscopic surgery, and the treatment effect was compared between the two groups. Results The CRP, peripheral blood glucose and length of stay in the observation group were better than those in the control group[(54.14±3.12)mg/L,(4.61±2.31)mmol/L,(6.23±1.24)d vs (76.42±3.24)mg/L,(7.32±2.34)mmol/L,(10.12±1.14)d], and the differences were obvious (t=6.342,6.412,6.641,P<0.05); and the usage rate of analgesic drugs and operative satisfactory rate in the observation group were better than those in the control group (10.0%, 86.6% vs 43.3%, 60.0%), and the differences were obvious (χ^2=8.241,9.201, P< 0.05), besides, the incidence rate of complications in the observation group was lower than that in the control group (6.6% vs 23.3%), and the difference was obvious(t=8.341,P<0.05). Conclusion The application of laparoscopic surgery in reducing the stress after the perforated appendicitis is of important significance, which can effectively reduce the postoperative stress reactions, with small wound and low incidence rate of complications, which can improve the treatment effect, and contribute to promoting the recovery of patients, therefore, it is worth clinical promotion and application.