加速康复外科理念联合腹腔镜技术对穿孔性阑尾炎患儿肠道功能恢复及外周血WBC、CRP、IL-6的影响

Effect of Concept of Accelerated Rehabilitation Surgery Combined with Laparoscopy on Intestinal Function Recovery and Peripheral Blood WBC,CRP, IL-6 in Children with Perforated Appendicitis

目的:探讨腹腔镜技术联合加速康复外科理念(ERAS)对穿孔性阑尾炎患儿肠道功能恢复及外周血白细胞计数(WBC)、C反应蛋白(CRP)、白介素-6(IL-6)的影响。方法:选取2017年8月~2019年8月期间我院收治的行腹腔镜下阑尾切除术的患儿120例,上述患儿根据随机数字表法分为对照组(n=60)和研究组(n=60),两组均给予腹腔镜下阑尾切除术治疗,对照组给予常规围手术期处理,研究组给予ERAS,比较两组围术期指标、WBC、CRP、IL-6水平,比较两组术后疼痛状况及满意度情况,记录两组治疗期间并发症发生情况。结果:研究组住院时间、首次排气时间、下床活动时间、首次进食时间较对照组短,住院费用少于对照组(P<0.05)。研究组术后3 d、术后5 d血清WBC、CRP、IL-6水平呈先升高后降低趋势(P<0.05);研究组术后3 d、术后5 d血清WBC、CRP、IL-6水平低于对照组(P<0.05)。研究组视觉疼痛模拟评分(VAS)评分低于对照组,而满意率则高于对照组(P<0.05)。术后并发症总发生率研究组低于对照组(P<0.05)。结论:ERAS联合腹腔镜技术治疗穿孔性阑尾炎患儿安全有效,可减轻患儿疼痛及炎性应激,促进其术后肠道功能恢复,减轻患儿家庭经济负担。

Objective: To investigate the effect of concept of accelerated rehabilitation surgery(ERAS) combined with laparoscopy on intestinal function recovery and peripheral blood leukocyte count(WBC), C-reactive protein(CRP), interleukin-6(IL-6) in children with perforated appendicitis. Methods: From August 2017 to August 2019, 120 children who underwent laparoscopic appendectomy in our hospital were selected, they were divided into two groups: control group(n=60) and study group(n=60). The two groups were treated with laparoscopic appendectomy, the control group was treated with routine perioperative treatment, the study group was treated with ERAS, and the operation indexes, WBC, CRP and IL-6 of the two groups were compared. The postoperative pain and satisfaction of the two groups were compared, and the complications during the treatment were recorded. Results: The hospitalization time,first exhaust time, getting out of bed activity time and first eating time of the study group were shorter than those of the control group, and the hospitalization cost was less than that of the control group(P<0.05). The levels of WBC, CRP and IL-6 of the study group increased first and then decreased at 3 d after operation and 5 d day after operation(P<0.05). The levels of WBC, CRP and IL-6 of the study group were lower than those of the control group(P<0.05). The visual pain simulation score(VAS) score of the study group was lower than that of the control group, while the satisfaction rate was higher than that of the control group(P<0.05). The total incidence rate of postoperative complications of the study group was lower than that of the control group(P<0.05). Conclusion: ERAS combined with laparoscopy is safe and effective in the treatment of children with perforated appendicitis, which can reduce pain and inflammatory stress,promote the recovery of intestinal function, and reduce the economic burden of children’s families.