回顾性比较子镜与内镜下逆行阑尾炎治疗术 对急慢性阑尾炎的疗效及安全性

Retrospective comparison of the efficacy and safety of Cholangioscopy and Endoscopic Retrograde Appendicitis Therapy in treatment of acute and chronic appendicitis

摘要:

［摘要］ 目的 比较子镜与X线辅助内镜下逆行阑尾炎治疗术(ERAT)对急慢性阑尾炎的疗效及安全性。方法 回顾性分析2023 年1 月至 2024 年 6 月江苏省人民医院消化内科收治的99例经结肠镜进行内镜下治疗的急慢性阑尾炎患者的临床资料,根据治疗方法不同,分为子镜组及X线组,比较两组患者手术相关指标(操作时间、术中放置支架、住院时间、住院费用)、治疗有效率、术后并发症(消化道出血、穿孔、腹膜炎、肠梗阻)及复发情况。结果 两组患者治疗有效率差异无统计学意义。子镜组患者的操作时间、住院时间均较X线组显著缩短,放置支架概率及复发率也较X线组明显减少,(P＜0.05) 。子镜组住院费用高于X线组,差异有统计学意义(P＜0.05)。两组并发症发生率均较少,差异无统计学意义。结论 应用子镜技术及X线辅助下ERAT治疗阑尾炎均安全有效。相较ERAT,子镜直视下操作手术时间、住院时间更短,同时能降低阑尾炎复发率,避免电离辐射,更适用于儿童及妊娠期阑尾炎。

Abstract:

[Abstract]: Objective To compare the efficacy and safety of Cholangioscopy and X-ray assisted Endoscopic Retrograde Appendicitis Therapy (ERAT) in the treatment of acute and chronic appendicitis. Method A retrospective analysis was conducted on the clinical data of 99 patients who underwent endoscopic treatment for acute and chronic appendicitis in the Department of Gastroenterology of Jiangsu Province Hospital from January 2023 to June 2024. The patients were divided into Cholangioscopy group and X-ray group according to different treatment methods.The relevant surgical indicators (operation duration, intraoperative stent placement, hospital stay and expenses), treatment efficacy, postoperative complications (bleeding, perforation, peritonitis and intestinal obstruction), and recurrence were compared. Results There was no significant difference in the effective rate between the two groups. Patients in Cholangioscopy group has shorter procedure time and hospital stay than X-ray group. Moreover the probability of stent placement and recurrence rate were also lower in Cholangioscopy group (P<0.05). However, the X-ray group has less hospital expenses(P<0.05). The incidence of complications was relatively low and did not significantly differ between the two groups. Conclusion The Cholangioscopy and X-ray assisted ERAT are both safe and effective in the treatment of appendicitis. Compared with X-ray assisted ERAT, ERAT combined with cholangioscopy demonstrates shorter procedure time and hospital stay duration, lower recurrence rate, and avoidance of ionizing radiation, which is more suitable for children and pregnant women with appendicitis.