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目的比较腹腔镜阑尾切除术(laparoscopic appendectomy,LA)和传统阑尾切除术(open appendectomy,OA)治疗小儿阑尾炎创伤反应的差异。方法从2002年5月至2004年2月收治160例小儿阑尾炎,其中行LA69例,OA91例,术前和术后12h采血,应用酶链免疫吸附试验测定血清白介素6(IL-6)和C反应蛋白(CRP)水平。结果手术时间:LA组(33±15)min比OA组(45±9)min短(t=6·40,P<0·01);住院时间:LA组(4·3±1·5)d比OA组(6·6±1·2)d短(t=10·91,P<0·01)。术后切口感染:LA组1例(1·5%),OA组10例(11·0%),两者之间差异有统计学意义(χ2=4·19,P<0·05)。OA组IL-6术后较术前升高值明显高于LA组[(60±20)pg/ml比(28±8)pg/ml,P<0·01]。CPR在OA组术后升高值亦明显高于LA组[(83±11mg/L比(24±6)mg/L,P<0·01]。结论LA治疗小儿阑尾炎较OA手术时间短、创伤小、恢复快、并发症少。
Objective To compare the differences of laparoscopic appendectomy (LA) and traditional appendectomy (OA) in the treatment of pediatric appendicitis. Methods From May 2002 to February 2004, 160 children with appendicitis were admitted. Among them, LA69 and OA91 patients were enrolled in this study. Blood samples were taken before and 12h after operation. Enzyme linked immunosorbent assay was used to determine the levels of serum interleukin-6 (IL-6) and C Reactive protein (CRP) levels. Results The operative time was shorter in LA group (33 ± 15) min than in OA group (45 ± 9) min (t = 6.40, P <0.01) d was shorter than that of OA group (6.6 ± 1.2) d (t = 10.91, P <0.01). Incision infection was found in 1 patient (1.5%) in LA group and 10.0% (11.0%) in OA group, with significant difference between the two groups (χ2 = 4.19, P <0.05). The elevation of IL-6 in OA group was significantly higher than that in LA group [(60 ± 20) pg / ml (28 ± 8) pg / ml, P <0.01]. CPR in OA group was also significantly higher than the LA group (83 ± 11mg / L (24 ± 6) mg / L, P <0.01] Conclusion LA treatment of appendicitis in children than OA surgery time is short, Small trauma, rapid recovery, fewer complications.