化脓性阑尾炎抗生素治疗后不同时机行腹腔镜阑尾切除术的效果

Effect of Laparoscopic Appendectomy at Different Opportunities after Antibiotic Treatment for Suppurative Appendicitis

目的:探究分析化脓性阑尾炎抗生素治疗后不同时机行腹腔镜阑尾切除术的效果。方法:回顾性分析盐城市大丰人民医院2020年1月-2022年8月收治的接受腹腔镜阑尾切除术治疗的化脓性阑尾炎患者88例。所有患者均在手术前采取抗生素治疗,根据不同的手术时机分为两组。患者抗生素治疗开始到接受手术的时间≤72 h设为试验组(n=42),患者抗生素治疗开始到接受手术的时间>72 h设为对照组(n=46)。对比两组炎症因子、围手术期相关指标、术后并发症发生率。结果:术前,两组白细胞计数、中性粒细胞、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平比较,差异均无统计学意义(P>0.05);术后,试验组白细胞计数、中性粒细胞、TNF-α、IL-8均明显低于对照组,差异均有统计学意义(P<0.05)。试验组手术时间、术后抗生素治疗时间及住院时间均明显短于对照组,术中出血量及医疗费用均少于对照组,差异均有统计学意义(P<0.05);两组胃肠功能恢复时间及引流管留置时间比较,差异均无统计学意义(P>0.05)。试验组术后并发症发生率为2.38%,对照组术后并发症发生率为6.52%,两组比较,差异无统计学意义(P>0.05)。结论:抗生素治疗开始到接受手术治疗的时间≤72 h可以减轻化脓性阑尾炎患者炎症反应,减少住院时间和治疗成本。所以选择手术时机的时候,如果条件允许,应该尽可能快得让患者接受治疗,以免影响患者预后,增加不必要的医疗费用。

Objective:To explore and analyze the effect of laparoscopic appendectomy at different opportunities after antibiotic treatment for suppurative appendicitis.Method:A total of 88 patients with suppurative appendicitis treated with laparoscopic appendectomy in Yancheng Dafeng People's Hospital from January 2020 to August 2022 were analyzed retrospectively.All patients were treated with antibiotic before operation and divided into two groups according to different operation opportunities.The time from the start of antibiotic treatment to the operation for patient≤72 h was set as the experimental group(n=42),and the time from the start of antibiotic treatment to the operation for patient>72 h was set as the control group(n=46).The inflammatory factors,perioperative period related indexes and postoperative complications were compared between the two groups.Result:Before operation,there were no significant differences in white blood cell count,neutrophils,tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)levels between the two groups(P>0.05).After operation,the white blood cell count,neutrophils,TNF-αand IL-8 in the experimental group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The operation time,postoperative antibiotic treatment time and hospitalization time in the experimental group were significantly shorter than those in the control group,and the intraoperative bleeding volume and medical expenses were less than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the recovery time of gastrointestinal function and indwelling time of drainage tube between the two groups(P>0.05).The postoperative complication rate in the experimental group was 2.38%,and that in the control group was 6.52%,the difference between the two groups was not statistically significant(P>0.05).Conclusion:The time from the start of antibiotic treatment to operation treatment≤72 h can reduce the inflammatory reaction of patients with suppurative appendicitis,and reduce the hospitalization time and treatment cost.Therefore,when choosing the operation opportunity,if conditions permit,patients should be treated as soon as possible,so as not to affect the prognosis of patients and increase unnecessary medical expenses.