内镜下逆行阑尾炎治疗术与腹腔镜阑尾切除术治疗急性单纯性阑尾炎的疗效及费用比较

Endoscopic Retrograde Appendicitis Therapy for Uncomplicated Acute Appendicitis: An Analysis of Efficacy and Impact on Hospitalization Costs

摘要: 目的：对比内镜下逆行阑尾炎治疗术(Endoscopic Retrograde Appendicitis Therapy, ERAT)和腹腔镜阑尾切除术(Laparoscopic Appendectomy, LA)在急性单纯性阑尾炎治疗中的临床效果及对医疗费用的影响，为临床治疗选择提供参考。方法：回顾性分析2024年6月至2025年1月广州中医药大学福田医院(福田)收治的40例急性单纯性阑尾炎患者，按治疗方式分为ERAT组和LA组，每组各20例。对比分析两组患者在手术时长、住院时间、总住院费用、体温恢复时间、术后首次下床时间、疼痛评分变化以及并发症发生率等方面的差异，以综合评价ERAT的疗效、安全性及经济性。结果：ERAT组患者的手术时间(52.25 ± 8.559 min)、住院时间(4(3, 4) d)、住院费用(12.24 ± 1.524千元)、体温恢复正常时间(5.075 ± 1.512 h)、ERAT组术后下床活动时间(4.372 ± 1.321 h)及并发症发生率(5%)方面均显著优于LA组，差异有统计学意义(P < 0.05)。结论：ERAT治疗急性单纯性阑尾炎临床效果确切，兼具微创、康复快、并发症少、费用低的优势，具备较高的临床推广应用价值。

Abstract: Objective: To compare the clinical efficacy and medical costs of Endoscopic Retrograde Appendicitis Therapy (ERAT) versus Laparoscopic Appendectomy (LA) in the treatment of acute simple appendicitis, and to provide a reference for clinical treatment selection. Methods: A total of 40 patients with acute simple appendicitis admitted to Futian Hospital, Guangzhou University of Chinese Medicine (Futian) from June 2024 to January 2025 were enrolled and divided into an ERAT group and an LA group according to treatment modality, with 20 cases in each group. Differences between the two groups were compared and analyzed in terms of operative time, length of hospital stay, total hospitalization costs, time to return to normal body temperature, time to first postoperative ambulation, changes in pain scores, and complication rates, in order to comprehensively evaluate the efficacy, safety, and cost-effectiveness of ERAT. Results: The ERAT group showed significantly better outcomes than the LA group in operative time (52.25 ± 8.559 min), length of hospital stay (4(3, 4) d), hospitalization costs (12.24 ± 1.524 thousand yuan), time to return to normal body temperature (5.075 ± 1.512 h), time to postoperative ambulation (4.372 ± 1.321 h), and complication rate (5%), with statistically significant differences (P < 0.05). Conclusion: ERAT achieves definite clinical efficacy in the treatment of acute simple appendicitis, offering advantages such as minimal invasiveness, faster recovery, fewer complications, and lower costs. It holds significant value for clinical promotion and application.