内镜下逆行阑尾炎治疗术对急性阑尾炎的疗效及对术后感染的预防研究

Endoscopic retrograde appendicitis for acute appendicitis and prevention of postoperative infection

目的探讨内镜下逆行阑尾炎治疗术对急性阑尾炎的疗效及对术后感染及其他并发症的预防效果。方法选择急性阑尾炎患者84例,随机分为对照组(42例)和观察组(42例)。对照组采用腹腔镜阑尾切除术治疗,观察组采用内镜下逆行阑尾炎治疗术治疗。对比两组手术时间、术后24 h疼痛情况、术后白细胞恢复正常时间、住院治疗时间以及感染等并发症发生情况。结果观察组手术操作时间、术后24 h VAS评分、白细胞恢复正常及住院治疗时间均少于或低于对照组(P<0.05);观察组术后仅出现腹腔残余脓肿及肠梗阻各1例,无感染情况发生,并发症总发生率4.76%(2/42);对照组伤口感染、腔内感染及腹腔残余脓肿各发生2例,肠梗阻3例,总发生率为21.43%(9/42),观察组并发症发生率明显更低(P<0.05)。结论内镜下逆行阑尾炎治疗术可明显缩短急性阑尾炎患者手术、白细胞恢复正常及住院治疗时间,降低术后疼痛程度,患者术后感染及肠梗阻等并发症少,疗效切确,可进行临床推广应用。

Objective To investigate the efficacy of endoscopic retrograde appendicitis in the treatment of acute appendicitis and the prevention of postoperative infection and other complications.Methods 84 patients with acute appendicitis were selected,they were randomly divided into control group(42 cases)and observation group(42 cases).The control group was treated with laparoscopic appendectomy,while the observation group was treated with endoscopic retrograde appendicitis.Comparisons were made between the two groups in terms of operation time,pain 24 hours after operation,recovery time of leucocytes after operation,hospitalization time and complications such as infection.Results The operation time,VAS score 24 hours after operation,leucocyte normalization and hospitalization time in the observation group were less than or lower than those in the control group(P<0.05).There were only 1 case of residual abdominal abscess and 1 case of intestinal obstruction in the observation group after operation,and no infection occurred.The total incidence of complications was 4.76%(2/42).In the control group,wound infection,intracavitary infection and residual abdominal abscess occurred in 2 cases,3 cases of intestinal obstruction.The total incidence of obstruction was 21.43%(9/42),and the incidence of complications in the observation group was significantly lower(P<0.05).Conclusion Endoscopic retrograde appendicitis can significantly shorten the time of operation,leucocyte return to normal and hospitalization in patients with acute appendicitis,reduce the degree of pain after operation,fewer complications such as infection and intestinal obstruction after operation,and the curative effect is accurate,so it can be popularized and applied in clinic.