目的:比较腹腔镜与开腹阑尾切除术治疗急性化脓性阑尾炎患者的效果。方法:回顾性分析2022—2024年该院收治的80例急性化脓性阑尾炎患者的临床资料,根据手术方法不同将其分为观察组和对照组各40例。观察组接受腹腔镜阑尾切除术治疗,对照...目的:比较腹腔镜与开腹阑尾切除术治疗急性化脓性阑尾炎患者的效果。方法:回顾性分析2022—2024年该院收治的80例急性化脓性阑尾炎患者的临床资料,根据手术方法不同将其分为观察组和对照组各40例。观察组接受腹腔镜阑尾切除术治疗,对照组接受开腹阑尾切除术治疗,比较两组围手术期指标(手术时间、术中出血量、术后首次排气时间、住院时间)水平、术后疼痛程度[视觉模拟评分法(VAS)]评分、术后应激反应指标(血清皮质醇、去甲肾上腺素)水平和术后并发症发生率。结果:观察组手术时间、术后首次排气时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组术后12、24 h VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组术后血清皮质醇、去甲肾上腺素水平均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%(2/40),低于对照组的22.50%(9/40),差异有统计学意义(P<0.05)。结论:腹腔镜阑尾切除术治疗急性化脓性阑尾炎患者可改善围手术期指标水平,降低疼痛程度评分、术后应激反应指标水平和并发症发生率,效果优于开腹阑尾切除术治疗。展开更多
BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases,especially the digestive system.Schistosome eggs are mainly deposited in the stomach,liver and colorectal,but a few eggs are deposi...BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases,especially the digestive system.Schistosome eggs are mainly deposited in the stomach,liver and colorectal,but a few eggs are deposited in the appendix and cause disease.At present,there are few studies on schistosomal appendicitis.AIM To explore the differences in epidemiological,clinical and pathological characteristics between schistosomal appendicitis and non-schistosomal appendicitis over the past decade in order to assess the impact of schistosomiasis on appendicitis.METHODS The differences of general data,clinical data and laboratory examination data of patients with appendicitis from October 2013 to October 2023 were retrospectively analyzed.All patients were divided into two groups for analysis.There were 136 patients in schistosomal appendicitis group and 5418 patients in non-schistosomal appendicitis group.RESULTS Schistosomal appendicitis accounted for 2.45%of all patients with appendicitis,and the annual proportion in the past decade was 2.2%,2.9%,1.8%,1.9%,3.4%,3.1%,1.9%,1.6%,3%,2.6%,respectively.The prevalence of schistosomal appendicitis was middle-aged and elderly males,with an average age of 61.73±15.335 years.The main population of non-schistosomal appendicitis was middle-aged men,with an average age of 35.8±24.013 years(P<0.001).The distribution of pathological types of appendicitis was different between the two groups(P<0.001).The incidence of acute suppurative appendicitis in non-schistosomal appendicitis was higher than that in schistosomal appendicitis[odds ratio(OR)=0.504;95%confidence interval(CI):0.349-0.728;P<0.001].The proportion of acute attack of chronic appendicitis in schistosomal appendicitis was higher than that in non-schistosomal appendicitis(OR=2.614;95%CI:1.815-3.763;P<0.001).The proportion of schistosomal appendicitis patients complicated with colorectal cancer was higher than that of nonschistosomal appendicitis patients(OR=5.087;95%CI:1.427-18.132;P=0.012).There was no difference in clinical symptoms between the two groups.In the laboratory examination,there was a significant difference in white blood cells between schistosomal appendicitis and non-schistosomal appendicitis.The level of white blood cells in schistosomal appendicitis group was slightly higher than the upper limit of the normal range.Other statistically significant indicators were in the normal range.CONCLUSION Schistosomal appendicitis is a severe condition that is often associated with intestinal malignancies,potentially leading to a poor prognosis.Schistosomal appendicitis is more likely to be misdiagnosed and missed diagnosed in clinical work because of its nonspecific clinical manifestations and laboratory examination.It is crucial to differentiate schistosomal appendicitis in middle-aged and elderly male patients presenting with appendicitis,and to ensure early detection and treatment.展开更多
文摘目的:比较腹腔镜与开腹阑尾切除术治疗急性化脓性阑尾炎患者的效果。方法:回顾性分析2022—2024年该院收治的80例急性化脓性阑尾炎患者的临床资料,根据手术方法不同将其分为观察组和对照组各40例。观察组接受腹腔镜阑尾切除术治疗,对照组接受开腹阑尾切除术治疗,比较两组围手术期指标(手术时间、术中出血量、术后首次排气时间、住院时间)水平、术后疼痛程度[视觉模拟评分法(VAS)]评分、术后应激反应指标(血清皮质醇、去甲肾上腺素)水平和术后并发症发生率。结果:观察组手术时间、术后首次排气时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);观察组术后12、24 h VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组术后血清皮质醇、去甲肾上腺素水平均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%(2/40),低于对照组的22.50%(9/40),差异有统计学意义(P<0.05)。结论:腹腔镜阑尾切除术治疗急性化脓性阑尾炎患者可改善围手术期指标水平,降低疼痛程度评分、术后应激反应指标水平和并发症发生率,效果优于开腹阑尾切除术治疗。
文摘BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases,especially the digestive system.Schistosome eggs are mainly deposited in the stomach,liver and colorectal,but a few eggs are deposited in the appendix and cause disease.At present,there are few studies on schistosomal appendicitis.AIM To explore the differences in epidemiological,clinical and pathological characteristics between schistosomal appendicitis and non-schistosomal appendicitis over the past decade in order to assess the impact of schistosomiasis on appendicitis.METHODS The differences of general data,clinical data and laboratory examination data of patients with appendicitis from October 2013 to October 2023 were retrospectively analyzed.All patients were divided into two groups for analysis.There were 136 patients in schistosomal appendicitis group and 5418 patients in non-schistosomal appendicitis group.RESULTS Schistosomal appendicitis accounted for 2.45%of all patients with appendicitis,and the annual proportion in the past decade was 2.2%,2.9%,1.8%,1.9%,3.4%,3.1%,1.9%,1.6%,3%,2.6%,respectively.The prevalence of schistosomal appendicitis was middle-aged and elderly males,with an average age of 61.73±15.335 years.The main population of non-schistosomal appendicitis was middle-aged men,with an average age of 35.8±24.013 years(P<0.001).The distribution of pathological types of appendicitis was different between the two groups(P<0.001).The incidence of acute suppurative appendicitis in non-schistosomal appendicitis was higher than that in schistosomal appendicitis[odds ratio(OR)=0.504;95%confidence interval(CI):0.349-0.728;P<0.001].The proportion of acute attack of chronic appendicitis in schistosomal appendicitis was higher than that in non-schistosomal appendicitis(OR=2.614;95%CI:1.815-3.763;P<0.001).The proportion of schistosomal appendicitis patients complicated with colorectal cancer was higher than that of nonschistosomal appendicitis patients(OR=5.087;95%CI:1.427-18.132;P=0.012).There was no difference in clinical symptoms between the two groups.In the laboratory examination,there was a significant difference in white blood cells between schistosomal appendicitis and non-schistosomal appendicitis.The level of white blood cells in schistosomal appendicitis group was slightly higher than the upper limit of the normal range.Other statistically significant indicators were in the normal range.CONCLUSION Schistosomal appendicitis is a severe condition that is often associated with intestinal malignancies,potentially leading to a poor prognosis.Schistosomal appendicitis is more likely to be misdiagnosed and missed diagnosed in clinical work because of its nonspecific clinical manifestations and laboratory examination.It is crucial to differentiate schistosomal appendicitis in middle-aged and elderly male patients presenting with appendicitis,and to ensure early detection and treatment.
