腹腔镜微创手术治疗小儿急性化脓性阑尾炎的疗效及对血清细胞因子的影响分析

Effect of Laparoscopic Minimally Invasive Surgery on Acute Suppurative Appendicitis in Children and Its Effect on Serum Cytokines

目的 探讨腹腔镜微创手术治疗小儿急性化脓性阑尾炎的疗效及对血清细胞因子的影响。方法 随机选取2019年1月—2021年1月就诊于泉州市第一医院的小儿急性化脓性阑尾炎患儿80例作为研究对象,以随机数表法分为对照组(开腹手术治疗)和观察组(腹腔镜微创手术治疗),各40例,比较两组患儿疗效、血清细胞因子指标、围术期指标和并发症发生情况。结果 观察组总有效率(95.00%)高于对照组(72.50%),差异有统计学意义(χ^(2)=7.439,P<0.05);术前,两组患儿血清细胞因子指标比较,差异无统计学意义(P>0.05),术后1 d时,观察组肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、可溶性细胞间黏膜分子-1(SICAM-1)、外周血白细胞(WBC)、C反应蛋白(CRP)均低于对照组,差异有统计学意义(P<0.05);观察组围术期指标与对照组比较,差异有统计学意义(P<0.05);观察组并发症发生率(5.00%)低于对照组(25.00%),差异有统计学意义(χ^(2)=6.274,P<0.05)。结论 临床治疗小儿急性化脓性阑尾炎可采用腹腔镜微创手术,比开腹手术所带来的创伤性更可控,可更好地控制机体血清细胞因子指标,进而提升疗效并促进恢复。

Objective To investigate the efficacy of laparoscopic minimally invasive surgery for the treatment of pediatric acute purulent appendicitis and the effect on serum cytokines obtained. Methods A total of 80 children with acute suppurative appendicitis who admitted to Quanzhou First Hospital from January 2019 to January 2021 were randomly selected as the subject of research, divided into control group(open abdominal surgery treatment) and observation group(minimally invasive laparoscopic surgical treatment) according to the ramdom number table, 40 cases in each, the treatment efficacy, serum cytokine markers, perioperative indicators and occurrence of complications were compared between the two groups of children. Results The total efficacy in the observation group(95.00%) was higher than that in the control group(72.50%), the difference was statistically significant(χ^(2)=7.439, P<0.05);before operation, comparison of the serum cytokine indexes between the two groups of children, the difference was not statistically significant(P>0.05), at 1 d after surgery, tumor necrosis factor-α(TNF-α), interleukin-8(IL-8), soluble intercellular adhesion molecule-1(SICAM-1),peripheral white blood leukocytes(WBC), and C-reactive protein(CRP) of the observation group were lower than those in the control group, the difference was statistically significant(P<0.05);the perioperative indicators of the observation group were compared with the control group, the difference was statistically significant(P<0.05);the incidence of complication in the observation group(5.00%) was lower than that in the control group(25.00%), and the difference was statistically significant(χ^(2)=6.274, P<0.05). Conclusions Laparoscopic minimally invasive surgery may be considered for the clinical treatment of pediatric acute septic appendicitis, which is more controllable than the trauma caused by open surgery and provides better control of body serum cytokine indicators, which in turn enhances the efficacy and promotes recovery.