目的 分析开腹手术及腹腔镜手术两种不同手术方式对急性阑尾炎患者临床疗效及对患者术后胃肠功能的影响.方法 选取2021年6月-2023年7月在西藏自治区拉萨市当雄县人民医院收治的110例急性阑尾炎患者作为研究对象,根据不同治疗方法将其分为开腹组和腹腔镜组,每组各55例.比较两组手术情况及手术前后胃肠功能指标变化,统计两组患者术后并发症发生率.结果 腹腔镜组患者手术切口长度、术中出血量、术后排气时间、排便时间及首次下床时间均少于开腹组,P<0.05;术后3d,两组患者胃泌素(GAS)、胃动素(MTL)及胆囊收缩素(CCK)水平均较术前有所下降,但腹腔镜组GAS、MTL及CCK各胃肠激素指标均高于开腹组,P<0.05;腹腔镜组患者术后重度疼痛、切口感染、腹腔脓肿、肠梗阻及肝脓肿等并发症总发生率低于开腹组,P<0.05.结论 相较于开腹手术,腹腔镜手术治疗急性阑尾炎疗效更为显著,能够更有效改善患者术后胃肠功能,减少并发症的发生,促进患者康复.
Objective To analyze the clinical efficacy and postoperative gastrointestinal function of two different surgical methods,open surgery and laparoscopic surgery,in patients with acute appendicitis.Methods 110 patients with acute appendicitis who were admitted to the People's Hospital of Dangxiong County,Lhasa City,Xizang Autonomous Region from June 2021 to July 2023 were selected as the study subjects.According to different treatment methods,they were split into the open team and the laparoscopic team,with 55 cases in each team.Compare the surgical conditions and changes in gastrointestinal function indicators before and after surgery between the two teams,and calculate the incidence of postoperative complications in the two teams of patients.Results The length of surgical incision,intraoperative bleeding,postoperative exhaust time,defecation time,and first time out of bed in the laparoscopic team were all shorter than those in the open team(P<0.05);three days after surgery,the levels of gastrin(GAS),motilin(MTL),and cholecystokinin(CCK)in both teams of patients decreased compared to before surgery,however,the gastrointestinal hormone indicators of GAS,MTL,and CCK in the laparoscopic team were higher than those in the open team(P<0.05);the incidence of postoperative complications such as severe pain,incision infection,abdominal abscess,intestinal obstruction,and liver abscess in the laparoscopic team was lower than that in the open team,P<0.05.Conclusion Compared to open surgery,laparoscopic surgery has a more significant therapeutic act on acute appendicitis,which can effectively improve postoperative gastrointestinal function,reduce the occurrence of complications,and promote patient recovery.