腹腔镜阑尾切除术治疗特殊类型的阑尾炎的技术分析和研究  

Analysis and study of laparoscopic appendectomy for unusual appendicitis

作　　者：江厚象[1] 潘凯[1] 夏利刚[1] 陈小春[1] 谢友龙[1] 洪英才[1] 

机构地区：[1]暨南大学医学院第二附属医院胃肠外科,广东深圳518020

出　　处：《中国内镜杂志》2005年第4期350-352,355,共4页China Journal of Endoscopy

摘　　要：目的总结腹腔镜阑尾切除术在特殊类型阑尾炎中的治疗体会。方法3年来该院共有78例特殊类型的阑尾炎患者采取LA,并且随机选择同期95例特殊类型阑尾炎非腹腔镜阑尾切除术作对照,对其手术适应证、手术方法、术后的恢复情况、术后疼痛和并发症及住院时间和费用等进行了回顾性分析。结果78例术后均经病理证实为阑尾炎,5例患者术中探查发现并存有其他疾病并且同时应用腹腔镜治愈,3例术前没有完全确诊,术中经腹腔镜探查确诊,1例因为腹腔广泛粘连而转为开腹。术后患者疼痛感轻微,无切口感染及院内感染,平均住院4.5d,住院费用与同期同类手术的差别无统计学意义。结论LA对于特殊类型的阑尾炎是一种较为理想的手术方式,具有损伤小,恢复快,可避免误、漏诊的优点。[Objective]To summarize the experience of the laparoscopic appendectomy for unusual appendicitis. Seventy-eight patients with unusual appendicitis were treated with laparoscopic appendectomy (LA) in three years, and ninety-five patients with unusual appendicitis which did not undergo LA were reviewed retrospectively. The operative procedure, surgical indications, recovery, postoperative pain, and complications, as well as the period and the cost for hospitalizing were studied. All Seventy-eight patients were confirmed appendicitis through pathology. Seventy-eight patients were operated smoothly. The preoperative diagnosis was not confirmed in three patients and the complication of other diseases were found in five cases with exploratory laparoscopy and were cured by LA at the same time. Only one patient was operated by abdominal incision during LA for the abroad conglutination in abdominal cavity. Postoperative complications, such as infection of the incision and pain were less occurred. The hospitalizing period was 4.5 days on the average and the difference of the cost was not significant with other procedures. [Conclusion] Most of unusual appendicitis can be early diagnosed and timely treated by LA. LA should be more ideal choice for the patients with unusual appendicitis since its obvious advantages of safe and minimal invasion. It has been an outstanding method in treating appendicitis compared to other traditional methods.

关 键 词：腹腔镜 阑尾炎 阑尾切除术 

分 类 号：R574.61[医药卫生—消化系统]