腹腔镜系膜剥离法阑尾切除术与腹腔镜常规阑尾切除术的效果比较

Comparison of Application Value Between Laparoscopic Mesangial Stripping Appendectomy and Laparoscopic Conventional Appendectomy

目的观察腹腔镜系膜剥离法阑尾切除术与腹腔镜常规阑尾切除术的应用价值。方法选取2020年6月-2021年6月在我院诊治的98例阑尾炎患者为研究对象,采用随机数字表法分为对照组和观察组,各49例。对照组采用腹腔镜常规阑尾切除术,观察组采用腹腔镜系膜剥离法阑尾切除术;比较两组临床手术指标、炎症因子指标、术后疼痛评分、标本从Trocar的取出率及并发症发生率。结果观察组手术时间、术中出血量、术后肛门排气时间、下床活动时间、住院时间均小于对照组,差异有统计学意义(P<0.05);术后,两组C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后两组疼痛评分比较,差异无统计学意义(P>0.05);观察组标本从Trocar取出率高于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论与常规腹腔镜阑尾切除术比较,腹腔镜系膜剥离法阑尾切除术手术时间短,术中出血量少,术后恢复快,可缩短住院时间,且标本从Trocar取出率高,患者术后炎症因子水平和并发症发生率低,应用效果显著。

Objective To observe the application value of laparoscopic mesangial stripping appendectomy and laparoscopic conventional appendectomy.Methods A total of 98 patients with appendicitis who were treated in our hospital from June 2020 to June 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,49 cases in each group.The control group was treated with laparoscopic conventional appendectomy,and the observation group was treated with laparoscopic mesangial dissection appendectomy.The clinical operation index,inflammatory factor index,postoperative pain score,specimen removal rate from Trocar and incidence of complications were compared between the two groups.Results The operation time,intraoperative blood loss,postoperative anal exhaust time,ambulation time and hospitalization time of the observation group were less than those of the control group,and the difference was statistically significant(P<0.05).After operation,C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the two groups were higher than those before operation,but the observation group was lower than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in pain score between the two groups after operation(P>0.05).The removal rate of specimens from Trocar in the observation group was higher than that in the control group,and the incidence of complications was lower than that in the control group(P<0.05).Conclusion Compared with conventional laparoscopic appendectomy,laparoscopic appendectomyal stripping appendectomy has the advantages of shorter operation time,less intraoperative bleeding,faster postoperative recovery and shorter hospital stay.At the same time,the high removal rate of Trocar,the low level of inflammatory factors and the low incidence of complications,which has significant application advantages and deserve clinical application.