【摘要】 目的比较腹腔镜手术与开腹手术治疗急性坏疽性阑尾炎的疗效及炎性因子变化情况。方法选取2015年1月至2017年12月接受阑尾切除术治疗的214例急性坏疽性阑尾炎患者,根据治疗方法不同分为观察组(143例)与对照组(71例),观察组患者接受腹腔镜阑尾切除术治疗,对照组患者接受开腹阑尾切除术治疗,分析两组患者手术前后血清炎性因子水平和疗效的相关指标。结果两组患者术前TNF-α、CRP比较差异无统计学意义(P>0. 05)。手术后,观察组患者血清TNF-α、CRP显著低于对照组,差异有统计学意义(P<0.05)。观察组患者手术时间显著长于对照组,术中出血量少于对照组,术后切口感染率低于对照组,术后肠鸣音恢复时间和术后住院时间显著短于对照组,差异有统计学意义(P<0.05)。结论与开腹阑尾切除术相比,急性坏疽性阑尾炎患者腹腔镜阑尾切除术后血清炎性因子水平下降更显著,术后恢复更快,疗效更好。更多还原

【Abstract】 Objective To compare the effect of laparoscopic appendectomy and open appendectomy in the treatment of acute gangrenous appendicitis and the changes of inflammatory factors.Methods 214 patients with acute gangrenous appendicitis who underwent appendectomy from January 2015 to December 2017 were divided into observation group( 143 cases) and control group( 71 cases) according to different treatment methods.The observation group received laparoscopic appendectomy,while the control group received open appendectomy.And then,the serum levels of inflammatory factors and related indicators of curative effect before and after operation in the two groups were analyzed. Results There was no statistically significant difference in tumor necrosis factor-α( TNF-α) and C-reactive protein( CRP) between the two groups before operation( P >0. 05).After operation,the serum levels of TNF-α and CRP in the observation group were significantly lower than those of the control group,difference was statistically significant( P< 0.05). The operation time of the observation group was significantly longer than that of the control group,the amount of bleeding was less,infection rate of postoperative incision was lower,and postoperative recovery time of bowel sounds and postoperative hospitalization time was significantly shorter than that of the control group,difference was statistically significant( P<0.05).Conclusion Compared with open appendectomy,the level of serum inflammatory factors in patients with acute gangrenous appendicitis after laparoscopic appendectomy decreases more significantly with faster recovery and better curative effect.更多还原