Analysis on Effects and Clinical Efficacy of Laparoscopic Appendectomy on Nutritional Status and Inflammatory Response of Elderly Patients with Appendicitis
CUI Kai, ZHOU Zipeng
Qinhuangdao Workers' Hospital, Hebei Qinhuangdao 066200, China
Abstract：Objective: To study the effects and clinical efficacy of laparoscopic appendectomy (LA) on nutritional status and inflammatory response of elderly patients with appendicitis. Methods: 80 elderly patients with appendicitis in our hospital from January 2017 to August 2018 were selected and divided into OA group and LA group according to the simple randomization, with 40 cases in each group. OA group was treated with OA, and LA group was treated with LA, and the two groups were observed until discharge. The levels of serum albumin, hemoglobin and serum total protein were measured before operation and at 3 d after operation in the two groups. Serum tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were measured before operation and at 3 d after operation were detected in the two groups. The perioperative indicators were counted in the two groups, and the first postoperative exhaust time, first feeding time, first ambulation time and hospital stay were counted in the two groups, and the incidence rate of postoperative complications during, follow-up was counted in the two groups. Results: On 3 d after operation, the levels of serum albumin, hemoglobin and serum total protein in LA group were higher than those in OA group (P<0.05). The levels of TNF-α, CRP and IL-6 in LA group were lower than those in OA group (P<0.05). The intraoperative blood loss and incision length in LA group were less than those in OA group (P<0.05). The first exhaust time, first feeding time, first ambulation time and hospital stay in LA group were shorter than those in OA group (P< 0.05). There was no significant difference in the incidence rate of postoperative complications between the two groups (P>0.05). Conclusions: LA is more beneficial to the recovery of elderly patients with appendicitis because of less trauma, and it can reduce inflammatory response and affect the nutritional status of patients.
崔凯, 周子鹏. 老年阑尾炎患者腹腔镜阑尾切除术对营养状态炎症反应的影响及临床效果分析[J]. 河北医学, 2020, 26(3): 473-477.
CUI Kai, ZHOU Zipeng. Analysis on Effects and Clinical Efficacy of Laparoscopic Appendectomy on Nutritional Status and Inflammatory Response of Elderly Patients with Appendicitis. HeBei Med, 2020, 26(3): 473-477.
[1] Van Rossem CC, Schreinemacher MH, Van Geloven AA, et al. Antibiotic duration after laparoscopic appendectomy for acute complicated appendicitis.[J]. JAMA Surg, 2016, 151(4):323~329. [2] Adams H L, Jaunoo S S. Hyperbilirubinaemia in appendicitis: the diagnostic value for prediction of appendicitis and appendiceal perforation[J]. Eur Trauma Emerg Surg, 2016, 42(2):249~252. [3] Vettoretto N, Cirocchi R, Randolph J, et al. Acute appendicitis can be treated with single incision laparoscopy: a systematic review of randomized controlled trials[J]. Colorectal Di, 2015, 17(4):281~289. [4] 胡峰,邵翀飞,黄伟强.超声与改良Alvarado评分对老年人急性阑尾炎的诊断价值[J].上海交通大学学报(医学版),2014,34(6):939~942. [5] 徐晓青,杨广承,王玉红,等.单孔、传统腹腔镜与常规开放阑尾切除手术治疗小儿阑尾炎的效果比较[J].中国地方病防治杂志,2017,32(12):1412. [6] 王东君,张新元,张震波,等.腹腔镜阑尾切除术治疗急性坏疽穿孔性阑尾炎[J].中国微创外科杂志,2016,16(4):380~381. [7] 吴华,程娟,吴国翠,等.人血白蛋白对腹部外科手术患者预后影响的系统评价[J].中华疾病控制杂志,2015,19(11):1162~1166. [8] Yi lmazlar F, Karabayirli S, Gozdemir M, et al. The effect of positive end-expiratory pressure on inflammatory cytokines during laparoscopic cholecystectomy[J]. Saudi Med, 2015, 36(11):1358~1362. [9] Slaats J, Ten O J, van de Veerdonk FL, et al. IL-1β/IL-6/CRP and IL-18/ferritin: distinct inflammatory programs in infections[J]. PloS Pathog, 2016, 12(12):e1005973. [10] 李晓欢,周鸿鲲,梅小平,等.腹腔镜下阑尾切除术治疗穿孔性阑尾炎的疗效及对围术期氧化应激和炎症反应的影响[J].中国普通外科杂志,2018,27(3):382~386. [11] 蒋安科,周庆,李强,等.腹腔镜阑尾切除术与开腹阑尾切除术治疗急性阑尾炎的疗效比较[J].现代生物医学进展,2015,15(24):4710~4712.
2020, Vol. 26 
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