两种手术方式治疗小儿阑尾炎的早期创伤反应及临床疗效比较

Comparison of early trauma response and clinical effect between two kinds of operation for appendicitis in children

目的比较开腹式手术与腹腔镜手术治疗小儿阑尾炎切除术后的早期创伤反应及治疗效果。方法2018年1月至2019年12月在我院手术治疗的230例小儿阑尾炎患者(≤14岁),根据手术方式不同分为观察组(采用腹腔镜手术方式,LA组)116例和对照组(采用传统开腹式手术方式,OA组)114例,比较两组患儿术前和术后血清白介素6(IL-6)、C反应蛋白(CRP)等创伤反应的炎性指标,以及手术时间、术中出血量、胃肠道恢复时间、术后发生并发症等情况。结果LA组患儿术后IL-6、CRP值低于OA组(P<0.05),手术时间和术后进食时间短于OA组(P<0.05),术中出血量少于OA组(P<0.05),两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论与开腹手术治疗小儿阑尾炎相比,腹腔镜手术治疗时间短、创伤反应小、恢复快,值得临床推广应用。

Objective To compare the early trauma response and therapeutic effect between laparoscopy and open surgery in the treatment of appendicitis in children.Methods Two hundred and thirty children(≤14 years old)with appendicitis were operated in our hospital from January 2018 to December 2019.The children were randomly divided into observation group(laparoscopic operation,LA group)and control group(traditional open operation,OA group)according to the operation methods.The inflammatory indexes such as serum IL-6 and C-reactive protein(CRP)as well as the operation time,intraoperative hemorrhage,gastrointestinal recovery time and postoperative complications were compared before and after operation.Results The values of IL-6 and CPR in the LA group were lower than those in the OA group(P<0.05).The time of operation,time of eating after operation and the amount of bleeding during operation in the LA group were shorter or less than those in the OA group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with laparotomy for appendicitis in children,laparoscopic surgery has shorter treatment time,less trauma response and faster recovery.