Comparative Analysis of the Curative Effect of Laparoscopic Appendectomy at Different Time for Suppurative Appendicitis
ZHANG Hong-jian,LI Rong-lin
Department of the Second General Surgery,Tianjin Ninghe District Hospital, Tianjin 301500, China
Abstract:
Objective To investigate the clinical effects of laparoscopic appendectomy at different times.Methods Select 70 cases of purulent appendicitis patients admitted to our hospital from June 2016 to June 2018,which were grouped according to the timing of surgery. 38 cases of patients with disease to operation time of 24 hours as the early group, with the disease to the time of operation. 32 cases of 72 hours patients as the extension group, and 32 cases of patients with surgery at the time of the disease is 72 hours as the extension group. Before the operation, they were given Chinese medicine filling and intravenous drip antibiotic treatment. To observe two groups the following indicators before and after surgery, such as white blood cell count, the percentage of neutral cells and the time of surgery, the flow of pus in surgery, the number of transit-opening abdominal cases,gastrointestinal function recovery time, postoperative antibiotic application time, the incidence of adverse reactions, the total length of hospitalization,hospitalization costs. Abdominal cavity drainage of the two groups of patients were measured bacterial culture. The positive rate of pathogenic bacteria in two groups of celiac seepage were compared. Results The preoperative white blood cell count and neutrophil percentage in the early group were (10.56±2.98)×109/L and (80.21±9.15)%, which was signi?cantly higher than those in the delayed group(8.07±3.04)×109/L and (68.75± 10.27)%. The difference was statistically significant (P<0.05). The early group of white blood cell count and neutrophil percentage in the postoperative group were (6.87±1.98)×109/L and (5.86±2.76)%. The delayed group was (6.92±2.17)×109/L and (5.63±3.01)%, which the difference was not statistically signi?cant (P>0.05). The early operation time [(60.18±14.39) min], intraoperative blood loss [(6.26±4.71) mL], gastrointestinal function recovery time [(2.07±0.76) d] and delayed operation time [(56.84±12.79) min], intraoperative blood loss [(5.14±3.49) mL], gastrointestinal function recovery time [(2.18±0.85) d] were compared, which the difference was not statistically significant (P>0.05). The pus drainage volume [(42.96±30.57) mL] and the postoperative antibiotic application time [(4.18±1.06) d] in the early group were signi?cantly higher than those in the delayed group. The drainage volume [(24.83±18.69) mL] and the postoperative antibiotic application time [(3.39±1.02) d] were measured, which the difference was statistically signi?cant (P<0.05). In the period group, 0 case was converted to open surgery, 2 cases had intestinal obstruction, 1 case had wound infection, the incidence of adverse events was 7.89%, 2 cases were converted to open surgery in the extended group, 1 case had intestinal obstruction, 1 case had wound infection, and the incidence of adverse events was 12.50%. The difference was not statistically significant (P>0.05). The positive rate of pathogenic bacteria in the early group was 28.95% (11 cases), and the delayed group was 12.50% (4 cases). Compared with the two groups, the early group was signi?cantly higher than the delayed group. The difference was statistically significant (P<0.05). The total group hospitalization time [(5.53±1.16) d], hospitalization expenses [(1.07±0.25) million], and the total hospitalization time [(7.69±1.83) d], hospitalization expenses [(1.28±0.31) million] were signi?cantly lower, which the difference was statistically signi?cant (P<0.05). Conclusion The early operation of laparoscopic and the delayed surgery of purulent appendicitis have reliable results. Delayed surgery has the advantages of less intraoperative pus drainage. It can shorten the antibiotic application time, but the total hospitalization time and hospitalization cost are higher. In the case of surgery, early surgery should be performed to promote physical recovery as soon as possible.
