开腹阑尾切除术后早期应用益生菌对穿孔性阑尾炎患儿术后康复的影响

Effect of the early application of probiotics after open appendectomy to postoperative recovery in children with perforated appendicitis

目的探讨开腹阑尾切除术后早期应用益生菌对穿孔性阑尾炎患儿术后康复的影响。方法选取50例急性穿孔性阑尾炎患儿,将其分为观察组和对照组,每组25例。所有患儿均急诊行开腹阑尾切除术,观察组在常规治疗的基础上于术后6 h开始口服益生菌治疗,对照组仅接受常规治疗。比较两组患儿术后肛门首次排气或排便时间、术后住院时间、术后抗生素使用时间,以及手术前后血清炎症因子水平。结果观察组患儿术后首次肛门排气或排便时间、术后住院时间均短于对照组(均P<0.05),而两组术后抗生素使用时间差异无统计学意义(P>0.05)。两组患儿术前白细胞计数及血清C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平比较,差异均无统计学意义(均P>0.05);术后第3天,两组患儿白细胞计数及血清CRP、IL-6、TNF-a水平均低于术前,且观察组患儿的血清CRP、IL-6、TNF-a水平均低于对照组(均P<0.05)。结论行开腹阑尾切除术后早期给予益生菌治疗,可以降低急性穿孔性阑尾炎患儿血清炎症因子水平,缩短术后首次排气或排便时间,促进术后肠道功能的恢复,减少术后住院时间。

Objective To explore the effect of the early application of probiotics after open appendectomy to postoperative recovery in children with perforated appendicitis.Methods A total of 50 children with acute perforated appendicitis were selected and divided into observation group or control group,with 25 cases in each group.All the children underwent emergency open appendectomy.The observation group began to be orally administrated probiotics 6 hours after surgery on the basis of routine treatment,while the control group only received routine treatment.The postoperative first anal exhaust time or defecation time,postoperative length of hospital stay,duration of postoperative antibiotic use,and pre-and postoperative levels of serum inflammatory factors were compared between the two groups.Results The postoperative first anal exhaust time or defecation time,and postoperative length of hospital stay in the observation group were shorter than those in the control group(all P<0.05),whereas there was no statistically significant difference in the duration of postoperative antibiotic use between the two groups(P>0.05).There were no statistically significant differences in preoperative white blood cell counts,and levels of serum C-reactive protein(CRP),interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)between the two groups(all P>0.05).On the third day after operation,the white blood cell counts and levels of serum CRP,IL-6 and TNF-αwere all lower than those before operation,and the observation group exhibited lower levels of serum CRP,IL-6,and TNF-αas compared with the control group(all P<0.05).Conclusion The early administration of probiotics after open appendectomy can decrease the levels of serum inflammatory factors in children with acute perforated appendicitis,shorten the postoperative first exhaust time or defecation time,promote the postoperative recovery of intestinal function,and reduce the postoperative length of hospital stay.