1.Impact of spectrum irradiation combined with operative laparoscopy on inflammatory reaction and immune function in children with appendicitis
Kechu HUANG ; Xuemin HONG ; Zhenzhen WU ; Dujian CHEN ; Zengjun LUO ; Dexu CHEN ; Jianping LIU ; Chengping ZHANG
China Journal of Endoscopy 2024;30(3):31-40
Objective To study the effect of spectrum irradiation combined with operative laparoscopy on inflammatory reaction and immune function in children with appendicitis.Methods 120 children with appendicitis from January 2022 to January 2023 were selected as the study subjects,randomly divided them into two groups using a random number table method:the control group(n = 60)and the study group(n = 60).The control group underwent laparoscopic minimally invasive appendectomy,and the study group underwent spectrum irradiation combined with laparoscopic minimally invasive appendectomy.The two groups compared perioperative recovery,procalcitonin(PCT),C-reactive protein(CRP)level,cellular immune function(CD4+,CD8+,and CD4+/CD8+),humoral immune function[immunoglobulin M(IgM),immunoglobulin G(IgG),C3,and C4],pain visual analogue scale(VAS),Alvarado score,and treatment effect and postoperative complication rate.Results Compared with the control group,the study group showed a significant reduction in the time to first anal exhaust and hospital stay after surgery,the differences were statistically significant(P<0.05).Compared with preoperative levels,the levels of PCT and CRP in both groups of patients increased at 12 and 24 h postoperatively,with the highest levels occurring at 12 h postoperatively;The PCT and CRP levels in the study group were lower than those in the control group at 12 and 24 h after surgery,the differences were statistically significant(P<0.05).Compared with preoperative data,the CD4+,CD8+,and CD4+/CD8+ levels decreased in both groups at 12 and 24 h postoperatively,with the lowest levels observed at 12 h postoperatively;The CD4+,CD8+,and CD4+/CD8+ levels in the study group were higher than those in the control group at 12 and 24 h after surgery,the differences were statistically significant(P<0.05).Compared with preoperative levels,the levels of IgM,IgG,C3,and C4 in both groups of patients decreased after surgery,with the lowest levels occurring 12 h after surgery;The levels of IgM,IgG,C3,and C4 in the study group were higher than those in the control group at 12 and 24 h after surgery,the differences were statistically significant(P<0.05).Compared with preoperative conditions,the VAS and Alvarado scores in both groups of patients decreased at 12 and 24 h after surgery.The VAS and Alvarado scores of the study group were lower than those of the control group at 12 and 24 h after surgery,the differences were statistically significant(P<0.05).Compared with the control group,the study group had a higher overall effective rate and a lower total incidence of complications,the differences were statistically significant(P<0.05).Conclusion Spectrum irradiation combined with operative laparoscopy can reduce postoperative inflammatory reaction,and improve immune function in children with appendicitis,shorten inflammatory reaction and immunosuppression time,reduce pain,and have a low incidence of postoperative complications,with ideal effect.