内镜下逆行阑尾炎治疗术治疗急性非复杂性阑尾炎的临床价值评价

Evaluation of clinical value of endoscopic retrograde appendicitis therapy in the treatment of acute uncomplicated appendicitis

目的 探索内镜下逆行阑尾炎治疗术在急性非复杂性阑尾炎患者中的应用效果。方法 90例急性非复杂性阑尾炎患者作为研究对象,根据住院号码单双号分为参照组和研究组,每组45例。参照组行腹腔镜阑尾切除术治疗,研究组行内镜下逆行阑尾炎治疗术治疗。比较两组患者的炎性因子[降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、临床指标、并发症发生情况。结果 术后,研究组患者的PCT、IL-6、CRP、TNF-α水平分别为(0.24±0.11)μg/L、(90.86±12.31)ng/ml、(7.15±1.18)mg/L、(3.50±1.63)ng/ml均显著低于术前的(3.64±1.52)μg/L、(142.27±35.19)ng/ml、(15.53±2.28)mg/L、(13.57±4.46)ng/ml;参照组患者的PCT、IL-6、CRP、TNF-α水平分别为(0.49±0.17)μg/L、(107.35±10.94)ng/ml、(9.06±0.45)mg/L、(4.28±1.19)ng/ml均显著低于术前的(3.62±1.48)μg/L、(140.86±37.52)ng/ml、(15.62±1.73)mg/L、(13.55±5.04)ng/ml;且研究组PCT、IL-6、CRP、TNF-α水平均显著低于参照组,差异具有统计学意义(P<0.05)。研究组患者的治疗费用(4.55±2.21)千元高于参照组的(2.32±1.15)千元,手术时间(45.37±5.18)min、下床活动时间(4.33±1.84)h、体温恢复正常时间(1.98±0.35)d、住院时间(3.32±0.91)d均短于参照组的(68.85±10.32)min、(9.86±1.79)h、(3.90±0.47)d、(5.84±2.16)d,差异具有统计学意义(P<0.05)。研究组并发症发生率6.67%低于参照组的37.78%,差异具有统计学意义(χ^(2)=12.600,P=0.000<0.05)。结论 内镜下逆行阑尾炎治疗术在急性非复杂性阑尾炎患者中应用效果理想,能够有效减轻患者炎症,且并发症少、安全性高,具备推广价值。

Objective To investigate the application effect of endoscopic retrograde appendicitis therapy in the treatment of acute uncomplicated appendicitis.Methods A total of 90 patients with acute uncomplicated appendicitis were selected as the research subjects,and they were divided into reference group and research group according to their hospitalization numbers,with 45 cases in each group.The reference group was treated with laparoscopic appendectomy,and the research group was treated with endoscopic retrograde appendicitis therapy.Both groups were compared in terms of levels of inflammatory factors[procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],clinical indicators and complications.Results After surgery,the levels of PCT,IL-6,CRP and TNF-αin the research group were(0.24±0.11)μg/L,(90.86±12.31)ng/ml,(7.15±1.18)mg/L,and(3.50±1.63)ng/ml,which were significantly lower than(3.64±1.52)μg/L,(142.27±35.19)ng/ml,(15.53±2.28)mg/L,and(13.57±4.46)ng/ml before surgery;the levels of PCT,IL-6,CRP and TNF-αin the reference group were(0.49±0.17)μg/L,(107.35±10.94)ng/ml,(9.06±0.45)mg/L,and(4.28±1.19)ng/ml,which were significantly lower than(3.62±1.48)μg/L,(140.86±37.52)ng/ml,(15.62±1.73)mg/L,and(13.55±5.04)ng/ml before surgery;the levels of PCT,IL-6,CRP,and TNF-αin the research group were significantly lower than those in the reference group,and the differences were statistically significant(P<0.05).In the research group,the treatment cost(4.55±2.21)thousand yuan was higher than(2.32±1.15)thousand yuan in the reference group;the operation time(45.37±5.18)min,the time to off-bed activity time(4.33±1.84)h,and the recovery time of body temperature(1.98±0.35)d and hospitalization time(3.32±0.91)d were shorter than(68.85±10.32)min,(9.86±1.79)h,(3.90±0.47)d,and(5.84±2.16)d in the reference group.All the differences were statistically significant(P<0.05).The complication rate 6.67%in the research group was lower than 37.78%in the reference group,and the difference was statistically significant(χ^(2)=12.600,P=0.000<0.05).Conclusion Endoscopic retrograde appendicitis therapy has ideal effect on patients with acute uncomplicated appendicitis,and can effectively reduce the inflammation of patients with few complications and high safety,which has the value of promotion.