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主管:陕西省卫生健康委员会
主办:西安心身医学研究所
   西安交通大学第一附属医院
国际标准刊号:ISSN2096—1413
国内统一刊号:CN61—1503/R

腹腔镜在急性化脓性阑尾炎手术中的应用

秦平

(陕西省蒲城县中医医院,陕西 渭南,715500)

浏览次数:89次 下载次数:419次

摘要:

目的 探讨腹腔镜在急性化脓性阑尾炎治疗中的临床效果。方法 选取我院2012年1月至2016年12月收治的急性化脓性阑尾炎患者122例,根据术式不同分为腹腔镜组(57例)和常规开腹组(65例),比较两组患者手术时间、术中出血量、手术切口长度、术后首次下床活动时间、术后肛门排气时间、术后镇痛药使用情况、术后并发症发生情况、住院天数及住院费用 等指标。结果 与常规开腹组比较,腹腔镜组术中出血量少、术后镇痛药使用率低,切口长度、术后首次下床活动时间、肛门排气时间及住院时间短,但住院费用多,差异有统计学意义(P<0.05);腹腔镜组术后并发症发生率为1.8%,低于常规开腹组的 13.9%,差异有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05)。结论 腹腔镜阑尾切除术治疗急性化脓 性阑尾炎疗效确切,可减轻患者痛苦、促进术后恢复、缩短住院时间、降低术后并发症的发生。

关键词:腹腔镜;急性化脓性阑尾炎;开腹手术

中图分类号:R656.8文献标志码:A文章编号:2096-1413(2017)30-0054-02

    Application of laparoscope in the surgical treatment of acute suppurative appendicitis
    QIN Ping
    (Traditional Chinese Medicine Hospital of Pucheng County, Weinan 715500, China)

    ABSTRACT: Objective To explore the clinical effect of laparoscopic appendectomy (LA) in the surgical treatment of acute suppurative appendicitis. Methods A total of 122 cases of patients with acute suppurative appendicitis treated in our hospital from January 2012 to December 2016 were selected and divided into LA group (n=57) and open appendectomy (OA) group (n=65) according to different surgical ways. The operation time, peri-operative bleeding, operative incision lengths, postoperative activity time, postoperative exhausting time, analgesic use situation, complications, hospital days and expenditure between the two groups were compared. Results The LA group resulted in a lower blood loss and analgesic use rate, shorter operative incision lengths, postoperative activity time, postoperative exhausting time and hospital days than the OA group, but the expenditure in LA group was more than OA group (P<0.05). The complication rate in LA group (1.8%) was lower than OA group (13.9%) (P<0.05). There was no significant difference in operation time between the two groups (P>0.05). Conclusion In the treatment of acute suppurative appendicitis, laparoscopic appendectomy can alleviate patient``s pain, promote postoperative recovery, shorten hospitalization time and reduce the postoperative complications.

    KEYWORDS: laparoscope; acute suppurative appendicitis; open appendectomy

    参考文献:
    [1] 李建华,韩玲.传统的疝修补术、无张力疝修补术、腹腔镜疝修补术临床疗效对照研究[J].中国内镜杂志,2012,18(6):636-639.
    [2] 陈志敏,王敬学,上官惠敏,等.腹腔镜阑尾切除术与开腹阑尾切除术疗效比较[J].中国现代医生,2011,49(4):122.
    [3] 幸天勇,赵小波,任亦星,等.腹腔镜阑尾切除术临床价值再探讨[J].中国普外基础与临床杂志,2011,18(9):982-986.
    [4] 张坤,钟桂华,林华,等.急性化脓性阑尾炎致严重感染性休克1 例 [J].第三军医大学学报,2005,27(23):2334.
    [5] KATKHOUDA N,MASON RJ,TOWFIGH S,et al.Laparoscopic versus open appendectomy: a prospective randomized double -blind study [J]. Ann Surg,2005,242(3):439-448.
    [6] 王有利,刘凡,叶颖江,等.腹腔镜阑尾切除术在急性和慢性阑尾炎中应用疗效的比较[J].中华普通外科杂志,2013,28(2):93-95.
    [7] 乔唐,蒋国庆,陈平,等.腹腔镜阑尾切除术与开腹阑尾切除术的对比研究[J].中国普外基础与临床杂志,2011,18(12):1327-1329.
    [8] 刘兴军,吴硕东,陈永生,等.经脐单切口与传统三孔腹腔镜阑尾切除术的回顾性对比研究[J].中国微创外科杂志,2016,16(9):784-786.
    [9] 张伟耀,周霞.腹腔镜阑尾切除术与开腹阑尾切除术的并发症大样本对比分析[J].中国全科医学,2014,17(3):322-324.
    [10] 陈本鑫,黄诚,余有声,等.行腹腔镜和开腹手术治疗老年急性化脓性阑尾炎临床观察[J].昆明医科大学学报,2011,32(12):125-127.

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