腹腔镜小切口阑尾切除术治疗急性阑尾炎对氧化应激、免疫及循环系统的影响

Influences of laparoscopic small incision appendectomy on oxidative stress, immunity and circulatory system in the treatment of acute appendicitis

目的探讨腹腔镜小切口阑尾切除术治疗急性阑尾炎对氧化应激、免疫及循环系统的影响。方法将我院收治的80例急性阑尾炎患者随机分为对照组[常规开腹阑尾切除术(OA)]和观察组[腹腔镜小切口阑尾切除术(LSA)],各40例。观察两组氧化应激、免疫及循环系统相关指标的变化。结果术后1d,对照组的SOD、IgG及IgM水平显著低于观察组与术前,MDA水平显著高于观察组与术前(P<0.05)。手术开始后30min,两组的HR、CVP及MAP均升高,且观察组高于对照组(P<0.05)。观察组术后4周的GLQI评分及美容评分高于对照组(P<0.05)。结论LSA治疗急性阑尾炎创伤小,能有效减少对氧化应激及免疫功能的影响,但对循环系统影响较大,应加强术中监测及预防措施。

Objective To investigate the influences of laparoscopic small incision appendectomy on oxidative stress,immunity and circulatory system in the treatment of acute appendicitis.Methods Eighty patients with acute appendicitis admitted in our hospital were randomly divided into control group[routine open appendectomy(OA)]and observation group[laparoscopic small incision appendectomy(LSA)],with 40 cases in each group.The indexes changes of oxidative stress,immunity and circulatory system were observed.Results One day after operation,the levels of SOD,Ig G and IgM in the control group were significantly lower than those in the observation group and before operation,and the level of MDA was significantly higher than that in the observation group and before operation(P<0.05).The HR,CVP and MAP of the two groups increased at 30 minutes after operation,and those of the observation group were higher than the control group(P<0.05).The GLQI score at 4 weeks after operation and cosmetic score of the observation group were higher than those of the control group(P<0.05).Conclusion LSA treatment of acute appendicitis has less trauma and can effectively reduce the effects of oxidative stress and immune function,but it has a greater impact on the circulatory system,so intraoperative monitoring and preventive measures should be strengthened.