数字胆胰管子镜系统直视下置入阑尾支架治疗急性阑尾炎的有效性分析

Efficacy analysis of appendiceal stent placement under direct vision of the digital cholangiopancreatic endoscopy system for acute appendicitis

摘要:

探讨数字胆胰管子镜系统直视下置入阑尾支架治疗急性阑尾炎的效果及预后。采用回顾性队列研究，收集2022年1月至2024年10月于淮安市第二人民医院接受内镜逆行阑尾炎治疗术（endoscopic retrograde appendicitis therapy，ERAT）治疗的急性阑尾炎患者相关资料，根据阑尾腔有无狭窄分为非狭窄组和狭窄组，再根据ERAT过程中有无放置阑尾支架分为支架组和非支架组。分析比较置入阑尾支架对急性阑尾炎患者的临床症状、手术相关指标及预后改善情况。共收集患者资料116例，非狭窄组患者放置支架与不放置支架分别为25例及37例，两组临床症状、手术相关指标及预后差异无统计学意义（P0.05）。狭窄组患者放置支架与不放置支架分别为31例及23例，支架组术后2 h疼痛程度轻于非支架组［1.00（0.00，3.00）分比3.00（1.00，3.00）分，Z=-2.452，P=0.014］，术后腹痛持续时间短于非支架组［3.00（0.00，5.00）h比5.00（3.00，10.00）h，Z=-2.756，P=0.006］，术中出血量少于非支架组［2.00（1.00，3.00）mL比4.00（2.00，5.00）mL，Z=-2.426，P=0.019］，随访6个月复发率低于非支架组［3.23%（1/31）比26.09%（6/23），χ2=6.116，P=0.039］。阑尾支架的置入可改善急性阑尾炎伴阑尾腔狭窄患者的病情及预后。

Abstract:

To investigate the efficacy and prognosis of appendiceal stent placement under direct vision using a digital cholangiopancreatic endoscope system for acute appendicitis, a retrospective cohort study was conducted. Relevant data of patients with acute appendicitis who received endoscopic retrograde appendicitis therapy (ERAT) at Huai''an Second People''s Hospital from January 2022 to October 2024 were collected. The patients were divided into non‑stenosis group and stenosis group according to the presence or absence of stenosis in the appendiceal lumen. Then, they were further divided into the stent group and the non‑stent group according to the placement of appendiceal stent during the ERAT procedure. The clinical symptoms, surgery‑related indicators, and prognosis improvement of patients with acute appendicitis were analyzed. A total of 116 patients'' data were collected. Among the patients in the non‑stenosis group, 25 cases received stent placement and 37 cases did not. There were no statistically significant differences in clinical symptoms, surgery‑related indicators, or prognosis between the two groups (P0.05). Among the patients in the stenosis group, 31 cases received stent placement and 23 cases did not. The pain level at 2 hours after the operation in the stent group was lower than that in the non‑stent group [1.00 (0.00, 3.00) points VS 3.00 (1.00, 3.00) points, Z=-2.452, P=0.014]. The duration of abdominal pain after the operation in the stent group was shorter than that in the non‑stent group [3.00 (0.00, 5.00) hours VS 5.00 (3.00, 10.00) hours, Z=-2.756, P=0.006]. The intraoperative blood loss in the stent group was less than that in the non‑stent group [2.00 (1.00, 3.00) mL VS 4.00 (2.00, 5.00) mL, Z=-2.426, P=0.019]. After a 6‑month follow‑up, the recurrence rate in the stent group was lower than that in the non‑stent group [3.23% (1/31) VS 26.09% (6/23), χ2=6.116, P=0.039]. The implantation of appendiceal stent can improve the condition and prognosis of patients with acute appendicitis accompanied by stenosis.