急性阑尾炎腹腔镜手术前后血清炎症因子水平及细胞免疫功能变化的研究

目的 研究急性阑尾炎腹腔镜手术前后血清炎症因子水平及细胞免疫功能变化。方法 选取2016年9月-2018年12月该院收治的急性阑尾炎患者86例为研究对象,采用抽签法随机分为观察组(n=43)和对照组(n=43),对照组行开腹阑尾切除术,观察组于腹腔镜下接受阑尾切除术,比较两组手术一般情况、手术前后血清降钙素原(PCT)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平、细胞免疫功能指标白细胞计数(WBC)、中性粒细胞计数(NEUT)、T淋巴细胞亚群(CD3~+、CD4~+、CD8~+和CD4~+/CD8~+)]及并发症。结果 观察组手术切口长度、术中出血量、术后排气时间和住院时间较对照组明显减少或缩短(P0.05),观察组住院费用高于对照组(P0.01);观察组术后血清PCT、IL-6和IL-8水平明显低于对照组(P0.01);观察组术后第1天WBC、NEUT低于对照组,而CD3~+、CD4~+较高于对照组,两组比较,差异均有统计学意义(P0.05);观察组并发症发生率9.30%低于对照组27.91%(P0.05)。结论 采用腹腔镜手术治疗急性阑尾炎有微创、机体免疫功能恢复好、炎症反应轻、安全性高和术后恢复快等优点,值得在临床推广实践。

Changes of serum inflammatory factors and cellular immune function before and after laparoscopic surgery for acute appendicitis

Abstract: Objective?To study the changes of serum inflammatory factors and cellular immune function before and after laparoscopic surgery for acute appendicitis.?Methods?86 patients with acute appendicitis from September 2016 to December 2018 were enrolled in the study. They were randomized into observation group and control group, 43 cases in each group. The control group was treated with open appendectomy, and the observation group was treated with appendectomy under laparoscopy. The general surgical conditions, levels of serum procalcitonin (PCT), interleukin-6 (IL-6) and interleukin-8 (IL-8), cellular immune function indexes white blood cell count (WBC), neutrophil count (NEUT), T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+)] and complications before and after operation were compared between the two groups.?Results?The length of surgical incision, intraoperative blood loss, postoperative exhaust time and hospitalization time in the observation group were significantly reduced or shortened compared with those in the control group (P?