摘要
目的探讨三孔法腹腔镜阑尾切除术治疗阑尾炎临床效果及对术中出血量与疼痛评分的影响。方法回顾性分析本院2017年6月至2020年2月期间收治的160例阑尾炎患者的临床病历资料,根据手术方式不同分为观察组(n=82例)与对照组(n=78例),对照组给予小切口阑尾切除术治疗,观察组给予三孔法腹腔镜阑尾切除术治疗,观察比较两组手术情况[手术时间、术中出血量、肛门排气时间、抗菌药物使用时间、住院时间]、术后VAS评分、炎症因子水平[TNF-α、IL-6、IL-8]及应激激素水平[皮质醇、去甲肾上腺素、血糖]、术后并发症。结果观察组术中出血量、手术时间、肛门排气时间、抗菌药物使用时间、使用镇痛药物、住院时间均低于对照组(P<0.05);观察组术后12h、24h、48h VAS评分低于对照组(P<0.05);观察组术后TNF-α、IL-6、IL-8水平均低于对照组(P<0.05);观察组术后皮质醇、去甲肾上腺素、血糖水平均低于对照组(P<0.05);观察组术后并发症发生率为2.44%,低于对照组的12.82%(P<0.05)。结论三孔法腹腔镜阑尾切除术治疗阑尾炎疗效确切,可有效减少术中出血量,减轻患者术后疼痛,降低机体炎症反应、应激反应及术后并发症。
Objective To explore the clinical effect of three-hole laparoscopic appendectomy(LA)in treatment of appendicitis and its influences on intraoperative blood loss and pain score.Methods The clinical medical data of 160 appendicitis patients admitted to the hospital between June 2017 and February 2020 were retrospectively analyzed.According to different surgical methods,they were divided into observation group(n=82)and control group(n=78).The control group underwent small-incision appendectomy,while observation group underwent three-hole LA.The surgical conditions[operation time,intraoperative blood loss,anal exhaust time,usage time of antibiotics,hospitalization time],postoperative score of visual analogue scale(VAS),levels of inflammatory factors[TNF-α,IL-6,IL-8]and stress hormones[cortisol,norepinephrine,blood glucose],postoperative complications were compared between the two groups.Results The intraoperative blood loss,operation time,anal exhaust time,usage time of antibiotics,analgesics usage and hospitalization time in observation group were all lower than those in control group(P<0.05).At 12h,24h,and 48h after surgery,VAS scores were lower in observation group than control group(P<0.05).After surgery,levels of TNF-α,IL-6 and IL-8 were lower in observation group than control group(P<0.05).After surgery,levels of cortisol,norepinephrine and blood glucose were lower in observation group than control group(P<0.05).The incidence of postoperative complications was lower in observation group than control group(2.44%vs12.82%)(P<0.05).Conclusion The clinical curative effect of three-hole LA is significant on appendicitis,which can reduce intraoperative blood loss,alleviate postoperative pain,reduce inflammatory response,stress response and incidence of postoperative complications.
作者
周桂勤
ZHOU Gui-qin(Department of General Surgery,Jiujiang Third People's Hospital,Jiujiang 332000,Jiangxi Province,China)
出处
《罕少疾病杂志》
2022年第8期82-84,共3页
Journal of Rare and Uncommon Diseases
