微创手术治疗化脓性急性阑尾炎的效果及对血清细胞因子的影响

Effect of Minimally Invasive Surgery on Suppurative Acute Appendicitis and its Effect on Serum Cytokines

目的观察微创手术治疗化脓性急性阑尾炎的效果及对血清细胞因子的影响。方法选取2019年5月-2021年5月我院诊治的62例化脓性急性阑尾炎患者为研究对象,采用随机数字表法分为对照组和观察组,各31例。对照组采用常规开腹手术治疗,观察组采用微创腹腔镜手术治疗,比较两组临床手术指标、血清细胞因子[C反应蛋白(CRP)、白细胞(WBC)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)]水平、疼痛(VAS)评分、并发症发生率。结果观察组手术时间长于对照组,术中出血量少于对照组,术后肛门排气时间、术后下床活动时间以及住院时间均短于对照组(P<0.05);观察组术后24 h的CRP、WBC、IL-8、TNF-α水平低于对照组(P<0.05);观察组术后2 h的VAS评分与对照组比较,差异无统计学意义(P>0.05),而观察组术后24、48 h的VAS评分低于对照组(P<0.05);观察组并发症发生率为6.45%,低于对照组的16.13%(P<0.05)。结论微创手术治疗化脓性急性阑尾炎的效果确切,可减少术中出血量,缩短术后恢复时间,且可降低血清细胞因子水平、并发症发生率以及疼痛程度,具有较理想的临床应用价值。

Objective To observe the effect of minimally invasive surgery on suppurative acute appendicitis and its effect on serum cytokines.Methods A total of 62 patients with suppurative acute appendicitis diagnosed and treated in our hospital from May 2019 to May 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 31 patients in each group.The control group was treated with conventional open surgery,and the observation group was treated with minimally invasive laparoscopic surgery.The clinical surgical indicators,serum cytokines[C-reactive protein(CRP),white blood cell(WBC),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]levels,pain(VAS)score,and complication rate were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,and the postoperative anal exhaust time,postoperative ambulation time and hospitalization time were shorter than those of the control group(P<0.05).The levels of CRP,WBC,IL-8 and TNF-αin the observation group were lower than those in the control group at 24 h after operation(P<0.05).There was no significant difference in VAS score between the observation group and the control group at 2 h after operation(P>0.05),while the VAS score of the observation group at 24 and 48 h after operation was lower than that of the control group(P<0.05).The incidence of complications in the observation group was 6.45%,which was lower than 16.13%in the control group(P<0.05).Conclusion Minimally invasive surgery is effective in the treatment of suppurative acute appendicitis,which can reduce intraoperative blood loss,shorten postoperative recovery time,and reduce serum cytokine levels,complication rates,and pain levels.It has ideal clinical application value.