内镜下逆行阑尾治疗术(ERAT)治疗单纯性阑尾炎的疗效及安全性

Efficacy and safety of endoscopic retrograde appendix therapy(ERAT)in the treatment of simple appendicitis

目的探究与分析内镜下逆行阑尾治疗术(ERAT)治疗单纯性阑尾炎的疗效及安全性.方法选取江油市第二人民医院自2017年4月-2019年4月收治的单纯性阑尾炎患者40例,采取随机数字表法分为内镜组与腹腔镜组,每组各20例,内镜组行内镜下逆行阑尾治疗术,腹腔镜组行腹腔镜阑尾切除术,对比两组围术期指标及并发症、手术前后炎症因子水平、随访1年复发率.结果内镜组与腹腔镜组相比,手术时间短、住院天数短、下床活动时间短、体温恢复正常时间短、白细胞恢复正常时间短,组间差异具有统计学意义(P<0.05).两组手术后与手术前相比,血清IL-6、PCT、TNF-α、CRP水平均较高,内镜组手术后与腹腔镜组手术后相比,血清IL-6、PCT、TNF-α、CRP水平均较低,组间差异具有统计学意义(P<0.05).内镜组与腹腔镜组相比,并发症发生率及随访1年复发率无明显差异(P>0.05).结论ERAT治疗单纯性阑尾炎的围术期指标更好,不容易引起严重的炎症反应,未增加并发症发生率及复发率,安全性有保证.

Objective To explore and analyze the efficacy and safety of endoscopic retrograde appendectomy(ERAT)in the treatment of simple appendicitis.Methods A total of 40 patients with simple appendicitis who were treated in our hospital from April 2017 to April 2019 were selected and divided into an endoscopic group and a laparoscopic group by random number table method,20 cases in each group,and the endoscopic group underwent endoscopic surgery.The retrograde appendectomy was performed under the microscope,and the laparoscopic group underwent laparoscopic appendectomy.The perioperative indicators and complications,the levels of inflammatory factors before and after surgery,and the recurrence rate during the 1-year follow-up were compared between the two groups.Results Compared with the laparoscopic group,the endoscopic group had shorter operation time,shorter hospitalization days,shorter time to get out of bed,shorter time for body temperature to return to normal,shorter time for white blood cells to return to normal,and the differences between groups were statistically significant(P<0.05).The levels of serum and CRP in the two groups after surgery were higher than those before surgery.IL-6,PCT,TNF-α,CRP levels in the endoscopic were lower than those in the laparoscopic group,and the difference between groups was statistically significant(P<0.05).Compared with the laparoscopic group,there was no significant difference in the complication rate and the 1-year follow-up recurrence rate between the endoscopic group and the laparoscopic group(P>0.05).Conclusion ERAT has better perioperative indicators in the treatment of simple appendicitis,is less likely to cause severe inflammatory reaction,does not increase the complication rate and recurrence rate,and is safe.