不同时机行腹腔镜阑尾切除术在化脓性阑尾炎患者中的效果分析

Analysis of the Effect of Laparoscopic Appendectomy at Different Times in Patients with Suppurative Appendicitis

目的探讨不同时机行腹腔镜阑尾切除术在化脓性阑尾炎患者中的应用效果。方法简单随机选取2019年3月—2020年3月该院收治的200例化脓性阑尾炎患者为研究对象,根据抗菌药物治疗至手术时机分为两组,其中研究组105例抗菌药物治疗时间≤48 h时实施腹腔镜阑尾切除术,对照组95例抗菌药物治疗时间>48 h时实施腹腔镜阑尾切除术。比较两组术中与术后情况,入院时与术后第2天的白细胞计数、中性粒细胞比例,炎症因子[肿瘤坏死因子α(TNF-α)与白细胞介素-8(IL-8)],以及术后并发症。结果研究组住院时间(4.20±1.28)d与住院费用(10220.52±854.60)元低于对照组(6.65±1.24)d、(15325.52±875.47)元,差异有统计学意义(t=13.719、41.700,P<0.05)。术后第2天,研究组白细胞计数(6.45±1.52)×10^(9)/L、中性粒细胞比例(5.32±2.03)%与对照组(6.52±1.65)×10^(9)/L、(5.62±3.00)%对比差异无统计学意义(t=0.312、0.835,P>0.05);TNF-α(1.52±0.30)mg/L、IL-8(33.02±6.52)ng/mL与对照组(1.53±0.29)mg/L、(33.42±5.03)ng/mL对比差异无统计学意义(t=0.239、0.482,P>0.05)。研究组术后并发症发生率3.81%低于对照组14.74%,差异有统计学意义(χ^(2)=7.272,P<0.05)。结论针对化脓性阑尾炎患者,早期实施腹腔镜阑尾切除术能够降低术后并发症概率,缩短住院时间,减少医疗成本。

Objective To explore the effect of laparoscopic appendectomy at different times in patients with suppurative appendicitis.Methods 200 patients with suppurative appendicitis treated in the hospital from March 2019 to March 2020 were simply randomly selected as the research objects.They were divided into two groups according to the time from antibacterial treatment to operation,105 patients in the study group were treated with antimicrobial drugs for≤48 h laparoscopic appendectomy was performed at the time,and 95 cases in the control group were performed laparoscopic appendectomy when the antibiotic treatment time was greater than 48 h.The intraoperative and postoperative conditions,the white blood cell count,neutrophil ratio,inflammatory factors[tumor necrosis factorα(TNF-α)and interleukin-8(IL-8)on admission and on the second day after surgery],and postoperative complications of the two groups were compared.Results The length of stay in the study group(4.20±1.28)d and the cost of hospitalization(10220.52±854.60)yuan were lower than those in the control group(6.65±1.24)d and(15325.52±875.47)yuan,and the difference were statistically significant(t=13.719,41.700,P<0.05).On the second day after surgery,the white blood cell count(6.45±1.52)×10^(9)/L and the proportion of neutrophils(5.32±2.03)%in the study group were compared with the control group(6.52±1.65)×10^(9)/L,(5.62±3.00)%,the difference was not statistically significant(t=0.312,0.835,P>0.05);TNF-α(1.52±0.30)mg/L,IL-8(33.02±6.52)ng/mL and the control group(1.53±0.29)mg/L,(33.42±5.03)ng/mL had no statistically significant difference(t=0.239,0.482,P>0.05).The postoperative complication rate of the study group was 3.81%lower than that of the control group 14.74%,and the difference was statistically significant(χ^(2)=7.272,P<0.05).Conclusion For patients with purulent appendicitis,early implementation of laparoscopic appendectomy can reduce the probability of postoperative complications,shorten the length of hospital stay,and reduce medical costs.