腹腔镜下逆行性阑尾切除术对儿童非复杂性阑尾炎患儿免疫功能及疾病复发的影响

Effects of Laparoscopic Retrograde Appendectomy on Immune Function and Disease Recurrence in Children with Uncomplicated Appendicitis

目的 探讨腹腔镜下逆行性阑尾切除术对儿童非复杂性阑尾炎患儿免疫功能及疾病复发的影响。方法 选取2018年1月至2020年12月于本院收治非复杂性阑尾炎患儿82例,按照随机分组方式分为对照组和观察组,各41例。对照组采用传统开腹阑尾切除术(OA)进行治疗,观察组给予腹腔镜下逆行性阑尾切除术进行治疗。比较两组患儿各项手术指标,于术前、术后1 d和术后3 d,比较两组患儿免疫功能情况,术后统计两组患儿并发症发生率及复发率。结果 观察组患儿手术时间、体温恢复时间、住院天数及卧床时间均明显低于对照组(P<0.05);术后1 d和术后3 d,观察组外周血T淋巴细胞(CD3+)、诱导性T细胞(CD4+)及CD4+/抑制性T细胞(CD8+)水平均明显高于对照组(P<0.05),且观察组CD8+水平明显低于对照组(P<0.05);术后观察组患儿并发症发生率明显少于对照组(P<0.05),两组患儿复发率无明显差异(P>0.05)。结论 腹腔镜下逆行性阑尾切除术可以提高非复杂性阑尾炎患儿手术疗效和免疫功能,减少并发症发生率,且不会增加复发率。

Objective To investigate the effect of laparoscopic retrograde appendectomy on immune function and disease recurrence in children with uncomplicated appendicitis.Methods A total of 82 children with uncomplicated appendicitis who were treated in our hospital from January 2018 to December 2020 were selected and randomly divided into control group and observation group with 41 cases in each group. The control group was treated with traditional open appendectomy(OA),and the observation group was treated with laparoscopic retrograde appendectomy. The surgical indicators of the two groups of children were statistically compared, and the immune function of the two groups of children was compared before and 1 day, 3 days after the operation.Results The operation time, body temperature recovery time, hospitalization days and bed rest time in the observation group were significantly lower than those in the control group(P<0.05). 1 and 3 days after surgery,(CD4+) and CD4+/suppressive T cells(CD8+) levels were significantly higher than those in the control group(P<0.05), and the CD8+ level in the observation group was significantly lower than that in the control group(P<0.05);postoperative complications were observed in the observation group. The total incidence was significantly lower than that in the control group(P<0.05),and there was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Laparoscopic retrograde appendectomy can improve the surgical efficacy and immune function of children with uncomplicated appendicitis, reduce complications, and will not increase the recurrence rate.