腹腔镜手术与开腹手术治疗穿孔性阑尾炎临床疗效比较

刘伟，朱帅，杜江

（延安市人民医院胃肠外科，陕西 延安，716000）

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摘要：

目的 评价腹腔镜手术治疗穿孔性阑尾炎的临床疗效和安全性。方法 采用随机平行对照临床试验设计方案，将我院收治的90例穿孔性阑尾炎患者随机分为试验组和对照组，每组45例。试验组患者给予腹腔镜切除术治疗，对照组患者给予开腹阑尾切除术治疗。比较两组患者的临床疗效，包括手术时间、排气时间、住院时间和手术出血量。同时，密切观察两组患者术后并发症的发生情况。结果 试验组患者的手术时间为（41.29±10.44）min，术后排气时间为（25.23±4.08）h，住院时间为（6.26±2.19）d，术中出血量为（36.58±16.27）mL；对照组患者的手术时间为（73.48±12.53）min、术后排气时间为（37.88±10.32）h、住院 时间为（9.73±4.86）d，术中出血量为（68.29±25.64）mL，试验组上述指标明显低于对照组，差异具有统计学意义（P<0.01）。两组术后并发症发生率比较，差异无统计学意义（P>0.05）。结论 腹腔镜手术治疗穿孔性阑尾炎的疗效优于开腹阑尾切除术，可作为穿孔性阑尾炎治疗的首选方法。

关键词：阑尾炎；腹腔镜；开腹阑尾切除术

中图分类号：R656.8文献标志码：A文章编号：2096-1413(2017)26-0076-02

Clinical effect comparison of laparoscopic appendectomy and open surgery in treatment

of perforated appendicitis
LIU Wei, ZHU Shuai, DU Jiang
(Department of Gastrointestinal Surgery, People``s Hospital of Yan``an, Yan``an 716000, China)

ABSTRACT: Objective To assess the clinical effect and safety of laparoscopic appendectomy for treating perforated appendicitis. Methods Ninety cases of perforated appendicitis patients were divided into study group and control group according to randomized controlled clinical trial design, with 45 cases in each group. The patients in the control group were given open appendectomy, while the patients in the study group received laparoscopic appendectomy. The clinical effects including operation time, exhaust time, length of hospital stay and surgical bleeding were compared between the two groups, and incidence of complications after surgery were observed. Results The operation time, exhaust time, length of hospital stay and surgical bleeding in the study group were (41.29±10.44) min, (25.23±4.08) h, (6.26±2.19) d and (36.58±16.27) mL respectively, while those were (73.48±12.53) min, (37.88±10.32) h, (9.73±4.86) d and (68.29±25.64) mL in the control group. The above indexes in the study group were significantly lower than those in the control group, the differences were statistically significant (P<0.01). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion The clinical efficacy of laparoscopic appendectomy was superior to the open surgery for treating perforated appendicitis, which could be applied in clinic.
KEYWORDS: appendicitis; laparoscopic; open appendectomy

参考文献：
[1] LIAO KF,LAI SW,LIN CL,et al.Appendectomy correlates with increased risk of pyogenic liver abscess: a population-based cohort study in Taiwan[J].Medicine,2016,95(26):e4015.
[2] CHEN D,YANG G,CHEN XC,et al.Motion acupuncture for musculoskeletal pain: principles and methods[J].Eur J Bio Med Res,2016,2(2):19-24.

[3] 王勇,彭永光,李奕瑾.开腹与腹腔镜阑尾切除术治疗穿孔性阑尾炎的临床效果比较[J].临床军医杂志,2015,43(1):10-13.
[4] CARTER JT,KAPLAN JA,NGUYEN JN,et al.A prospective, randomized controlled trial of single-incision laparoscopic vs conventional 3-port laparoscopic appendectomy for treatment of acute appendicitis [J].J Am Coll Surg,2014,218(5):950-959.
[5] COSTI R,LEBIAN A,SMADJAC,et al.A rare case of appendicitis -like syndrome: prompt laparoscopic diagnosis and management[J].J Emerg Med,2013,44(4):773-776.
[6] 李乐,李鑫,景化忠,等.腹腔镜手术治疗坏疽及穿孔性阑尾炎的探讨[J].中国普外基础与临床杂志,2015,22(7):828-831.
[7] 黄华俊,陈满宇.腹腔镜手术治疗穿孔性阑尾炎对机体炎症反应的影响[J].临床急诊杂志,2015,16(7):517-519.
[8] 阚雄文,张松柏,谢雄伟,等.腹腔镜治疗小儿穿孔性阑尾炎对血清C反应蛋白和降钙素原的影响[J].中国微创外科杂志,2013,13(6):496-499.
[9] SESIA SB,BERGER E,HOLLAND -CUNZ S,et al.Laparoscopy -assisted single -port appendectomy in children: safe alternative also for perforated appendicitis?[J].Medicine,2015,94(50):e2289.
[10] TSENG CJ,SUN DP,LEE IC,et al.Factors associated with small bowel obstruction following appendectomy:a population-based study[J]. Medicine,2016,95(18):e3541.