腹腔镜下阑尾切除术治疗穿孔性阑尾炎的临床疗效及安全性分析

孙建斌

（陕西省潼关县人民医院，陕西 渭南，714300）

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摘要：

目的 分析腹腔镜下阑尾切除术治疗穿孔性阑尾炎的效果及安全性。方法 选取2014年10月至2016年10月我院收治的32例穿孔性阑尾炎患者，按随机数字表法分为对照组和观察组，各16例。对照组患者实施开腹阑尾切除术，观察组患者实施腹腔镜下阑尾切除术。对比两组手术指标，术后恢复情况，手术前、后IL-6、CRP、PCT水平变化情况和并发症发生率。结果 观察组切口长度、术中出血量、手术用时均少于对照组（P<0.05）；术后下床活动时间、进食时间、肛门排气时间及需要镇痛药例数均少于对照组（P<0.05）；两组手术前IL-6、CRP、PCT水平差异无统计学意义（P>0.05），手术后，观察组上述指标明显低于对照组（P<0.05）；观察组并发症发生率为12.50%，明显低于对照组的43.75%（P<0.05）。结论 采用腹腔镜阑尾切除术治疗穿孔性阑尾炎效果显著，可减少术中出血量、手术用时，加快患者术后恢复，且并发症发生率较低，安全性较高。

关键词：腹腔镜；阑尾切除术；穿孔性阑尾炎

中图分类号：R656.8文献标志码：A文章编号：2096-1413(2017)19-0053-02

Clinical efficacy and safety of laparoscopic appendectomy in the treatment of patients with perforated appendicitis
SUN Jian-bin
(People``s Hospital of Tongguan County, Weinan 714300, China)

ABSTRACT: Objective To analyze the clinical efficacy and safety of laparoscopic appendectomy in the treatment of perforated appendicitis. Methods Thirty -two cases of perforated appendicitis patients admitted in our hospital from October 2014 to October 2016 were selected, and divided into control group and observation group according to random number table method, with 16 cases in each group. The control group received open appendectomy, and the observation group carried out laparoscopic appendectomy. The operation indexes, postoperative recovery, changes of IL-6, CRP and PCT levels before and after surgery and the incidence of complications were compared between the two group. Results In the observation group, the incision length, intraoperative bleeding loss and operation time were less than those in the control group (P<0.05); the postoperative ambulation time, eating time, anal exhaust time and number of analgesic requirements were less than those in the control group (P<0.05); there was no significant difference in IL-6, CRP and PCT levels between the two groups before surgery (P>0.05), after surgery, those of the observation group were significantly lower than the control group (P<0.05); the incidence rate of complications in the observation group was 12.50% , which was significantly lower than 43.75% in the control group (P<0.05). Conclusion Laparoscopic appendectomy applied in the treatment of perforated appendicitis has significant effect, which can reduce the amount of bleeding during operation and time of operation and accelerate the recovery of patients after surgery, with lower incidence of complications and high safety.
KEYWORDS: laparoscopy; appendectomy; perforated appendicitis

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