关键词: 急性阑尾炎, Karl-storz, 腹腔镜阑尾切除术, 临床疗效, 免疫功能, 炎症反应

Abstract: Objective To investigate the clinical efficacy of modified Karl-Storz single-port laparoscopic surgery for acute appendicitis and its effect on immune function and inflammatory response.Methods A total of 78 patients with acute appendicitis admitted to our hospital from August 2019 to January 2020 were selected.According to the different treatment methods,they were divided into the observation group with modified Karl-Storz single-port laparoscopic surgery(n = 40) and the control group with traditional laparoscopic surgery(n=38).The perioperative index,immune function index,pain index and complications were compared in the two groups.Results The operation time and the extubation time in the observation group and the control group were(47.26±6.33)min and(45.87±6.28)min,(2.15±0.84)h and(2.23±0.89)h,respectively.The bed rest time was(16.46±4.37)h and(17.82±4.51)h after operation,respectively.There was no significant difference between the two groups(P＞0.05).The amount of intraoperative bleeding in the observation group was(16.24±3.11)ml,the time to recovery of intestinal function was(12.14±1.56) h,and the duration of hospitalization was(4.91±1.43) d,while that in the control group was(20.15±3.26)ml,(13.85±1.67) h and(6.02±1.58) d,respectively(P＜0.05).There was no significant difference in the levels of CD3+,CD4+,CD8+ and the ratio of CD4+/CD8+ between the two groups 1d before operation and 7d after operation(P>0.05).On day 1 after surgery,the ratios of CD3+,CD4+,CD8+ and CD4+/CD8+ in the observation group were significantly different from those in the control group(P＜0.05).There were no statistical difference in serum levels of inflammatory factors TNF-α,IL-6,IL-8,and CRP at 1d before surgery(P>0.05).Higher serum inflammatory factors in both groups at 3d later than preoperative(P＜0.05),and the serum levels in the observed group were significantly lower than the control group(P＜0.05).The VAS scores of the observation group at 12 h,24 h,36 h,48 h and 72 h after operation were significantly lower than those of the control group(P＜0.05).There was no significant difference in postoperative complications between the two groups(P＞0.05).Conclusion Compared with traditional laparoscopic appendectomy,modified Karl-storz single-port laparoscopic surgery is effective in treating acute appendicitis.

Key words: acute appendicitis, Karl storz, laparoscopic appendectomy, clinical efficacy, immune function, inflammatory response