Abstract:

Objective　To compare the effects of laparoscopic and open appendectomy on patients with appendicitis and their effects on Visual Analog Scale (VAS) score. Methods　Retrospective analysis was performed on the clinical data of 104 patients with appendicitis admitted to Huangshi Maternal and Child Health Care Hospital from October 2021 to October 2022. According to different surgical methods, they were divided into a conventional group (open appendectomy, 52 cases) and an observation group (laparoscopic appendectomy, 52 cases). In the observation group, there were 30 males and 22 females, aged (39.63±7.25) years, and the time from onset to operation was (20.36±5.85) h. In the conventional group, there were 31 males and 21 females, aged (39.89±8.14) years, and the time from onset to operation was (21.58±6.74) h. Surgery related indexes, pain status, nucleotide-binding oligomeric domain-like receptor protein 3 (NLRP3) in peripheral blood mononuclear cells, secretory crimp-associated protein-5 (SFRP-5), and postoperative complications were compared between the two groups. χ² test and t test were used. Results　The operation time, getting out of bed time, exhaust time, and length of hospital stay in the observation group were shorter than those in the conventional group (all P<0.05). Compared with the preoperative results, the VAS scores were decreased in both groups 12 h after surgery (both P<0.05), and the VAS score in the observation group 12 h after surgery was lower than that in the conventional group [(2.59±0.28) points vs. (4.69±0.33) points] (P<0.05). There were no statistically significant differences in the NLRP3 mRNA and SFRP-5 between the two groups before surgery (both P>0.05). Compared with the preoperative results, the NLRP3 mRNA and SFRP-5 in the two groups were decreased 3 d after surgery (all P<0.05), and the NLRP3 mRNA and SFRP-5 in the observation group were lower than those in the conventional group (both P<0.05). The total complication rate of the observation group was lower than that of the conventional group [5.77% (3/52) vs. 21.15% (11/52)] (P<0.05). Conclusion　Laparoscopic appendectomy for appendicitis has good effect, which can shorten the operation time, getting out of bed time, exhaust time, and length of hospital stay, reduce the VAS score, inflammatory reaction, and total incidence of complications, and is worthy of clinical promotion and application.

Key words:

Appendicitis；Laparoscope；Operation time；Getting out of bed time；Exhaust time；Length of hospital stay；Visual Analog Scale； , Complications

摘要：

目的　对比腹腔镜与开腹阑尾切除术对阑尾炎患者的手术效果及对视觉模拟评分法（VAS）评分的影响。方法　回顾性分析2021年10月至2022年10月黄石市妇幼保健院收治的104例阑尾炎患者的临床资料，依据手术方式的不同分为常规组（采用开腹阑尾切除术治疗，52例）和观察组（采用腹腔镜阑尾切除术治疗，52例）。观察组男30例，女22例，年龄（39.63±7.25）岁，发病至手术时间（20.36±5.85）h；常规组男31例，女21例，年龄（39.89±8.14）岁，发病至手术时间（21.58±6.74）h。对比两组患者手术相关指标、疼痛状况、外周血单核细胞中核苷酸结合寡聚化结构域样受体蛋白3（NLRP3）、分泌型卷曲相关蛋白-5（SFRP-5）、术后并发症发生情况。采用χ²检验、t检验。结果　观察组手术时间、下床时间、排气时间、住院时间均短于常规组（均P<0.05）。与术前相比，两组患者术后12 h VAS评分均降低（均P<0.05），观察组术后12 h VAS评分低于常规组［（2.59±0.28）分比（4.69±0.33）分］（P<0.05）。两组患者术前NLRP3 mRNA、SFRP-5比较，差异均无统计学意义（均P>0.05）；与术前相比，两组患者术后3 d NLRP3 mRNA、SFRP-5均降低（均P<0.05），观察组术后3 d NLRP3 mRNA、SFRP-5均低于常规组（均P<0.05）。观察组并发症总发生率低于常规组［5.77%（3/52）比21.15%（11/52）］（P<0.05）。结论　阑尾炎采用腹腔镜阑尾切除手术治疗效果较好，可以缩短患者的手术时间、下床时间、排气时间、住院时间，降低VAS评分，减轻患者的炎性反应，降低并发症总发生率，值得在临床上推广与应用。

关键词:

阑尾炎, 腹腔镜, 手术时间, 下床时间, 排气时间, 住院时间, 视觉模拟评分法, 并发症