| 姚丹丹,赵成鹏,段永福,等.单孔腹腔镜与传统开腹阑尾切除术对急性阑尾炎病儿血清免疫指标及红细胞沉降率的影响[J].安徽医药,2026,30(9):1848-1852. |
| 单孔腹腔镜与传统开腹阑尾切除术对急性阑尾炎病儿血清免疫指标及红细胞沉降率的影响 |
| Effects of single-port laparoscopic appendectomy and traditional open appendectomy on serum immune indexes and erythrocyte sedimentation rate in children with acute appendicitis |
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| DOI：10.3969/j.issn.1009-6469.2026.09.028 |
| 中文关键词: 阑尾炎 单孔腹腔镜阑尾切除术 免疫功能 红细胞沉降率 儿童 |
| 英文关键词: Appendicitis Single-port laparoscopic appendectomy Immune function Erythrocyte sedimentation rate Children |
| 基金项目:南阳市科技发展计划项目( 23KJGG123) |
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| 中文摘要: |
| 目的探讨单孔腹腔镜阑尾切除术( SPLA)与传统开腹阑尾切除术( OA)对急性阑尾炎病儿血清免疫指标及红细胞沉降率(ESR)的影响。方法回顾性选取 2022年 5月至 2024年 5月南阳市中心医院收治的 98例急性阑尾炎病儿作为研究对象，根据手术方式不同分成 OA组、 LA组，各 49例。比较两组病儿的围术期指标、炎症因子［C反应蛋白( CRP)、肿瘤坏死因子 α(TNF-α)、降钙素原( PCT)］、免疫功能［免疫球蛋白( Ig)G、IgM］、 ESR水平以及术后并发症。结果 LA组术中出血量低于 OA组，肛门排气时间、下床活动时间均短于 OA组( P<0.05)两组手术时间差异无统计学意义( P>0.05)。 CRP、TNF-α、PCT、IgG、 IgM、ESR水平的组间、时间及交互对比差异有统计学意义(，P<0.05)。两组术前 1d，术后 1、7d的 CRP、TNF-α、PCT水平均呈先上升后下降的趋势，且 LA组术后 1、7d的 CRP、TNF-α、PCT水平均低于 OA组( P<0.05)。两组术前 1d，术后 1、7d的 IgG、IgM水平均呈先下降后上升趋势，且 LA组术后 1、7d的 IgG［术后 7d:(12.33±1.46)g/L比( 10.03±1.66)g/L］、 IgM［术后 7d:(1.46±0.23)g/L比( 1.25±0.19)g/L］水平均高于 OA组( P<0.05)。两组术前 1d，术后 1、3、7d的 ESR水平均呈先上升后下降趋势，且 LA组术后 1、3、7d［(14.31±2.41)mm/第 1小时末比( 19.27±3.25)mm/第 1小时末］的 ESR水平均低于 OA组( P<0.05)。 LA组术后并发症总发生率为 4.08%(2/49)，低于 OA组的 16.33%(8/49)(P<0.05)。结论相较于 OA，SPLA能有效促进急性阑尾炎病儿术后康复，降低炎症反应，改善体液免疫功能和 ESR水平，减少术后并发症的发生风险，有一定临床推广价值。 |
| 英文摘要: |
| Objective To investigate the effects of single-port laparoscopic appendectomy (SPLA) and traditional open appendectomy(OA) on serum immune indexes and erythrocyte sedimentation rate (ESR) in children with acute appendicitis.Methods A total of 98 children with acute appendicitis admitted to Nanyang Central Hospital from May 2022 to May 2024 were retrospectively selected as theresearch subjects. They were divided into an OA group and an SPLA group according to different surgical methods, with 49 cases ineach group. The perioperative indexes, inflammatory factors [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), procalcitonin(PCT)], immune function [immunoglobulin (Ig) G, IgM], ESR levels, and postoperative complications were compared between the twogroups.Results Intraoperative blood loss in the SPLA group was lower than that in the OA group, and the time to first flatus and timeto ambulation were shorter than those in the OA group (P<0.05). There was no statistically significant difference in operation time be. tween the two groups (P>0.05). The levels of CRP, TNF-α, PCT, IgG, IgM, and ESR showed statistically significant differences betweengroups, across time points, and in their interaction effects (P<0.05). The levels of CRP, TNF-α, and PCT in both groups at 1 day beforesurgery and 1 and 7 days after surgery showed a trend of initially increasing and then decreasing. The levels of CRP, TNF-α, and PCT in the SPLA group at 1 and 7 days after surgery were lower than those in the OA group (P<0.05). The levels of IgG and IgM in bothgroups at 1 day before surgery and 1 and 7 days after surgery showed a trend of initially decreasing and then increasing. The levels ofIgG [7 days after surgery: (12.33±1.46) g/L vs. (10.03±1.66) g/L] and IgM [7 days after surgery: (1.46±0.23) g/L vs. (1.25±0.19) g/L] in the SPLA group at 1 and 7 days after surgery were higher than those in the OA group (P<0.05). The ESR levels in both groups at 1 daybefore surgery and 1, 3, 7 days after surgery showed a trend of initially increasing and then decreasing. The ESR levels in the LA groupat 1, 3, and 7 days after surgery [7 days: (14.31±2.41) mm/end of 1st hour vs. (19.27±3.25) mm/end of 1st hour] were lower than those in the OA group (P<0.05). The total incidence of postoperative complications in the SPLA group was 4.08% (2/49), which was lower thanthat in the OA group 16.33% (8/49) (P<0.05).Conclusions Compared with OA, SPLA can effectively promote postoperative recoveryin children with acute appendicitis, reduce the inflammatory response, improve humoral immune function and ESR levels, and reducethe risk of postoperative complications. It has promising clinical application value. |
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