经脐单孔腹腔镜联合频谱照射治疗小儿阑尾炎的疗效及对血清CRP、PCT水平的影响

Effect of Transumbilical Single-port Laparoscopy Combined with Spectrum Irradiation in Treatment of Appendicitis in Children and Its Effect on Serum CRP and PCT Levels

目的探讨经脐单孔腹腔镜联合频谱照射治疗小儿阑尾炎的疗效及对血清C反应蛋白(CRP)、降钙素原(PCT)水平的影响。方法选取2018年1月至2020年1月安徽理工大学附属亳州医院收治的66例小儿阑尾炎患者为研究对象,根据治疗方法不同分为对照组和试验组,各33例。对照组采用传统开腹阑尾切除术联合频谱照射治疗,试验组采用经脐单孔腹腔镜联合频谱照射治疗。比较两组手术相关指标、住院时间、切口美观满意度评分,术前和术后第5天炎症因子(CRP、PCT)水平变化、疼痛视觉模拟评分(VAS),以及术后并发症发生情况。结果试验组患者的手术时间长于对照组[(55.41±6.34)min比(43.21±5.52)min](P<0.01),术中出血量少于对照组[(9.91±3.31)mL比(21.91±6.49)mL](P<0.01),首次排气时间、首次进食时间、体温恢复正常时间、下床活动时间、住院时间短于对照组[(20.88±3.41)h比(27.41±3.17)h,(0.41±0.13)d比(1.67±0.23)d,(18.67±3.87)h比(25.37±4.29)h,(0.45±0.15)d比(1.44±0.47)d,(4.58±0.83)d比(7.12±0.74)d](P<0.01),切口美观满意度评分高于对照组[(4.10±0.51)比(3.12±0.33)](P<0.01)。血清CRP、PCT水平及VAS评分的组间和时点间存在交互作用(P<0.01),术后两组血清CRP、PCT水平及VAS评分低于术前(P<0.05),试验组低于对照组(P<0.05)。试验组术后总并发症发生率低于对照组[9.09%(3/33)比33.33%(11/33)](P<0.05)。结论与传统手术联合频谱照射相比,脐单孔腹腔镜联合频谱照射治疗小儿阑尾炎具有创伤小、术后恢复快、疼痛及炎症反应轻、切口美观度高的优势,且术后并发症发生率低。

Objective To explore the efficacy of transumbilical single-port laparoscopy combined with spectrum irradiation in the treatment of appendicitis in children and its effect on serum C-reactive protein(CRP)and procalcitonin(PCT)levels.Methods A total of 66 pediatric appendicitis patients admitted to Bozhou Hospital of Anhui University of Science and Technology From Jan.2018 to Jan.2020 were included.According to different treatment methods,the children were divided into a control group and a test group,with 33 cases in each group.The control group was treated with traditional open appendectomy combined with spectrum irradiation,and the test group was treated with transumbilical single-port laparoscopy combined with spectrum irradiation.The operation-related indicators,hospital stay time,incision aesthetic satisfaction scores,changes in inflammatory factors(CRP,PCT)levels and visual analogue pain score(VAS)before and on the 5th day after surgery,and postoperative complications were compared between the two groups.Results The operation time of the test group was longer than that of the control group[(55.41±6.34)min vs(43.21±5.52)min](P<0.01),and the intraoperative blood loss was less than that of the control group[(9.91±3.31)mL vs(21.91±6.49)mL](P<0.01),the first exhaust time,first meal time,time to return to normal body temperature,time to get out of bed,hospital stay time were shorter than those of the control group[(20.88±3.41)h vs(27.41±3.17)h,(0.41±0.13)d vs(1.67±0.23)d,(18.67±3.87)h vs(25.37±4.29)h,(0.45±0.15)d vs(1.44±0.47)d,(4.58±0.83)d vs(7.12±0.74)d](P<0.01),and the incision aesthetic satisfaction score was higher than that of the control group(4.10±0.51 vs 3.12±0.33)(P<0.01).Serum CRP,PCT levels and VAS scores had interactions between groups and time points(P<0.01),the levels of serum CRP,PCT,and VAS scores in the two groups after surgery were lower than those before surgery(P<0.05),and the test group was lower than the control group(P<0.05).The total incidence of postoperative complications in the test group was lower than that in the control group[9.09%(3/33)vs 33.33%(11/33)](P<0.05).Conclusion Compared with traditional surgery combined with spectrum irradiation,transumbilical single-port laparoscopy combined with spectrum irradiation for the treatment of appendicitis in children has the advantages of smaller trauma,faster postoperative recovery,less pain and inflammation,high incision aesthetics,and low postoperative complications.