内镜逆行阑尾炎治疗术对阑尾炎术后感染的预防价值

Prevention value of endoscopic retrograde appendicitis treatment for postoperative infection of patients with appendicitis

摘要:

目的分析内镜逆行阑尾炎治疗术对阑尾炎术后感染的预防价值。方法采用随机数字表将71例急性阑尾炎患者分为2组，观察组35例，行内镜逆行阑尾炎治疗术；对照组36例，行腹腔镜阑尾切除术。对比2组手术指标、术后不良事件、疼痛评分及血清炎性因子水平。结果观察组较对照组手术时间长，术中出血量少，术后卧床时间和住院时间短（P＜0.05）。观察组术后主要不良事件为复发，对照组为感染，2组总并发症发生率差异无统计学意义（P＞0.05）。术后12 h观察组疼痛评分低于对照组（P＜0.05）。术后2组血清超敏C-反应蛋白、白介素1β、白介素6及肿瘤坏死因子α水平均较术前有明显降低，且观察组低于对照组；白介素4和白介素10水平均有明确提高，且观察组高于对照组（P＜0.05）。结论内镜逆行阑尾炎治疗术在维持阑尾炎患者血清炎性因子平衡、预防感染方面可能存在积极作用，具有进一步研究的价值。

Abstract:

ObjectiveTo analyze the prevention value of endoscopic retrograde appendicitis treatment （ERAT） for postoperative infection of patients with appendicitis. MethodsA total of 71 patients with acute appendicitis were selected and divided into two groups， 35 patients in the observation group were treated with ERAT， and 36 patients of the control group underwent laparoscopic appendectomy. The operation indicators， postoperative adverse events， pain scores， and levels of serum inflammatory factors were compared between the two groups. ResultsThe observation group got a longer operation time， less bleeding， shorter in-bed and hospital stay， and lower hospital cost （all P＜0.05）. The main postoperative adverse event was recurrence in the observation group and infection in the control group， and the total adverse event rate was no significantly different between the two groups （P>0.05）. Twelve hours after treatment， the pain score of the observation group was lower than that of the control group （P＜0.05）. The post-operational serum levers of hypersensitivity C reactive protein， interleukin 1β， interleukin 6， and tumor necrosis factor α decreased in both groups， while the serum levers of interleukin 4 and interleukin 10 increased， especially in the observation group （all P＜0.05）. ConclusionERAT is more conducive to balance serum inflammatory factors and stabilize immune function compared with laparoscopic appendectomy， which can effectively prevent postoperative infection.