摘要
【目的】探讨腹腔镜手术联合中药治疗急性坏疽穿孔性阑尾炎的临床应用价值。【方法】采用回顾性分析方法,根据术后是否使用中药将78例急性坏疽穿孔性阑尾炎患者分为观察组47例和对照组31例。2组患者均给予腹腔镜手术切除阑尾治疗,对照组患者术后仅使用西药抗感染治疗,观察组患者术后在对照组西药抗感染治疗的基础上加用大黄牡丹汤加减方口服治疗,疗程为7 d。观察2组患者的手术情况、术后情况及并发症发生情况,并分析2组患者治疗前后白细胞计数(WBC)、中性粒细胞百分数(NEU)的变化情况。【结果】(1)手术情况:78例患者的平均手术时间为(75.49±30.52)min,平均术中出血量为(7.09±6.72)mL,术中引流管留置率为61.7%。(2)术后情况:2组患者的术后体温比较,差异无统计学意义(P>0.05);但观察组患者的术后首次排气时间及住院时间均短于对照组,差异均有统计学意义(P<0.05)。(3)并发症情况:2组患者均无切口感染、肠梗阻、肠黏连、腹腔残余脓肿、粪瘘等并发症发生。(4)炎症指标情况:治疗后,观察组患者的WBC和NEU水平均降低(P<0.05),而对照组患者的WBC水平降低,NEU水平升高(P<0.05);组间比较,观察组患者的NEU水平低于对照组,差异有统计学意义(P<0.05)。【结论】腹腔镜手术联合中药治疗急性坏疽穿孔性阑尾炎疗效确切,与术后单纯西药治疗相比,联合中药治疗有助于缩短术后首次排气时间及住院时间。
Objective To investigate the clinical value of laparoscopic surgery combined with Chinese medicine therapy for the treatment of acute gangrenous and perforated appendicitis.Methods A retrospective analysis was performed on 78 patients with acute gangrenous and perforated appendicitis who were admitted to the Department of Thyroid and Gastrointestinal Surgery,the First Affiliated Hospital of Guangzhou University of Chinese Medicine.According to the postoperative treatment schedule(medication with Chinese medicine or not),the 78 patients were divided into observation group(47 cases)and control group(31 cases).All of the patients were given laparoscopic surgery for appendectomy,and then the control group was given postoperative anti-infection treatment,and the observation group was given postoperative anti-infection treatment together with oral use of modified Dahuang Mudan Decoction.The treatment for the two groups lasted 7 days.The clinical outcomes included operative observation indexes,postoperative observation indexes,postoperative complications,and the pre-and posttreatment count of white blood cells(WBC)and neutrophils(NEU)of the two groups.Results(1)In respect of the operative observation indexes,the mean surgery time for the 78 patients was(75.49±30.52)min,mean surgical blood loss was(7.09±6.72)mL,and operative drainage tube implantation rate was 61.7%.(2)In respect of the postoperative observation indexes,the difference of postoperative body temperature between the observation group and control group was not statistically significant(P>0.05),but the time for the first postoperative flatus and the hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).(3)In respect of the postoperative complications,no complications of incision infection,intestinal obstruction,intestinal adhesion,abdominal residual abscess,or fecal fistula were found in the two groups.(4)After treatment,the inflammatory indexes of WBC count and
作者
梁咏欣
赵先明
LIANG Yong-Xin;ZHAO Xian-Ming(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Second Dept.of General Surgery,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2021年第3期480-483,共4页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
急性坏疽穿孔性阑尾炎
腹腔镜手术
大黄牡丹汤加减方
术后首次排气时间
住院时间
acute gangrenous and appendicitis
laparoscopic surgery
modified Dahuang Mudan Decoction
time for the first postoperative flatus
hospitalization time
