Geng Jianlei,Niu Huizhong,Fan Yanhui,et al.Effects of visible precision operation on inflammatory stress responses and immune functions in children undergoing laparoscopy for acute appendicitis[J].Journal of Clinical Pediatric Surgery,2020,19(07):641-647.[doi:10.3969/j.issn.1671-6353.2020.07.016]
超声可视化技术在急性阑尾炎腹腔镜手术患儿围手术期的应用
- Title:
- Effects of visible precision operation on inflammatory stress responses and immune functions in children undergoing laparoscopy for acute appendicitis
- Keywords:
- Appendicitis/SU; Laparoscopy; Postoperative Complications; Immunity
- 分类号:
- R614.1;R656.8;R619+.3
- 摘要:
- 目的 探讨超声可视化技术在急性阑尾炎腹腔镜手术患儿围手术期的应用价值。方法 选取2017年8月至2019年8月期间河北省儿童医院收治的急性阑尾炎患儿88例为研究对象，遵循随机化原则分为对照组和实验组，每组各44例。对照组予腹腔镜手术治疗，实验组借助超声可视化技术进行腹腔镜手术治疗。比较两组术前、术后治疗效果（术后呕吐、腹胀、喂养反复、腹腔残余感染发生率）、中性粒细胞（neutrophilic granulocyte，NEUT）］、炎症因子[C反应蛋白（C-reactive protein，CRP）、降钙素原（procalcitonin，PCT）、白介素6（Interleukin-6，IL-6）]、细胞免疫功能（CD4+、CD8+、CD4+/CD8+）、体液免疫功能[免疫球蛋白M （IgM）、免疫球蛋白G （IgG）、C3、C4]变化情况。结果 实验组患者术后呕吐、腹胀、喂养反复、腹腔残余感染发生率均低于对照组（P<0.05）；实验组患者的住院时间短于对照组，住院费用也低于对照组（P<0.05）。两组术前CRP、PCT、IL-6、CD4+、CD8+、CD4+/CD8+、IgM、IgG、C3、C4比较差异均无统计学意义（P>0.05）；两组术后CD4+、CD8+、CD4+/CD8+、IgM、IgG、C3、C4均显著降低，CRP、PCT、IL-6均显著升高，与术前比较差异有统计学意义（P<0.05），且实验组术后CRP、PCT、IL-6低于对照组，CD4+、CD8+、CD4+/CD8+、IgM、IgG、C3、C4高于对照组（P<0.05）。结论 超声可视化技术在腹腔镜手术治疗急腹症患儿围手术期应用可指导临床治疗，为患儿快速康复提供新思路。
- Abstract:
- Objective To explore the application of visible precision operation in the perioperative period of children undergoing laparoscopy for acute appendicitis.Methods From August 2017 to August 2019,a total of 88 hospitalized children with acute abdomen were enrolled.They were randomly divided into experimental group (n=44) and control group (n=44).Children in control group underwent laparoscopy while experimental group were assisted with visible precision operation for laparoscopy.The preoperative and postoperative levels of treatment effect (postoperative vomiting, abdominal distension, repeated feeding, incidence of residual abdominal infection),C-reactive protein (CRP),procalcitonin (PCT),interleukin-6 (IL-6),CD4+,CD8+,CD4+/CD8+,IgM,IgG,C3 and C4 were compared between two groups.Results The incidence of postoperative vomiting, abdominal distension, repeated feeding, and residual abdominal infection in the experimental group were lower than that in the control group (P<0.05); the hospitalization time of the experimental group was shorter than the control group, and the hospitalization cost was also lower than the control group (P<0.05).Before operation,no significant inter-group differences existed in the levels of CRP,PCT,IL-6,CD4+,CD8+,CD4+/CD8+,IgM,IgG or C3/C4 (P>0.05); Compared to pre-operation,the levels of CD4+,CD8+,CD4+/CD8+,IgM,IgG and C3/C4 levels significantly decreased on postoperatively in both groups while the postoperative levels of CRP,PCT,IL-6 significantly increased in both groups (P<0.05).There were significant inter-group postoperative differences in the above parameters (P<0.05).Conclusion Visible precision operation has excellent perioperative outcomes in children with acute appendicitis.
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备注/Memo
收稿日期:2019-11-26。
基金项目:河北省卫生健康委科研基金项目（编号：20190801）
通讯作者:牛会忠,Email:nrlnhz@163.com