腹腔镜阑尾切除术中系膜不同处理方法的比较  

Comparative study of mesoappendix electrocoagulation and Hem-o-lok clip occlusion in laparoscopic appendectomy

作　　者：董鹏 姜永胜[2] 沈海玉[2] 高兴华[2] 郑春宁[2] 孙少川[2] 

机构地区：[1]平阴县第二人民医院,山东济南250400 [2]山东大学附属济南中心医院

出　　处：《腹腔镜外科杂志》2010年第7期556-558,共3页Journal of Laparoscopic Surgery

摘　　要：目的:比较腹腔镜阑尾切除术(laparoscopic appendectomy,LA)"阑尾系膜电凝法"和"Hem-o-lok夹闭法"的临床效果。方法:2008年5月至2009年5月随机将210例LA患者分为两组,分别采用"阑尾系膜电凝法"(A组)和"Hem-o-lok夹闭法"(B组)处理阑尾系膜,对比其治疗效果。结果:210例均顺利完成LA,无中转开腹。B组与A组的平均手术时间分别为(40.05±3.48)min和(47.19±5.66)min(P<0.01),住院费用为(5 655.72±399.41)元和(4 701.11±550.34)元(P<0.01),术后体温恢复正常时间(29.10±7.03)h和(40.20±15.20)h(P<0.01);术后第1次肛门排便或排气时间平均为(27.41±3.80)h和(28.03±4.01)h(P>0.05),平均住院(3.75±0.87)d和(3.69±0.94)d(P>0.05)。结论:Hem-o-lok易掌握,止血牢靠,可缩短手术时间,患者创伤小,系膜电凝法节省住院费用,两种系膜处理方法均可靠。Objective：To compare the clinical effects of mesoappendix electrocoagulation and Hem-o-lok occlusion in laparoscopic appendectomy（LA）.Methods：Two hundred and ten cases of appendicitis were treated by LA using either electrocoagulation（group A） or Hem-o-lok clip（group B） to ligate the mesoappendix from May 2008 to May 2009.The therapeutic effect of the two groups were compared.Results：LA was successfully completed in 210 cases without conversions to open surgery or any iatrogenic injury.The operating time in Hem-o-lok group was significantly shorter [（40.05±3.48）min] than that in electrocoagulation group [（47.19±5.66）min ]（P0.01）.The hospitalization cost in Hem-o-lok group which was（5 655.72±399.41）yuan was more than that in electrocoagulation group which was（4 701.11±550.34）yuan（P0.01）.The time of recovery to normal body temperature in Hem-o-lok group was（29.10±7.03）h,which was less than that of（40.20±15.20）h in electrocoagulation group（P0.01）.No significant difference was observed between the two groups in the time of restoration of gastrointestinal function,which was（27.41±3.80）h and（28.03±4.01）h.The postoperative hospital stay was（3.75±0.87）d in Hem-o-lok group and（3.69±0.94）d in electrocoagulation group（P0.05）.Conclusions：Hem-o-lok clip is easy to be mastered,and it can decrease operating time and trauma with reliable hemostasis.Electrocoagulation can save the hospitalization fees.The two methods of treating the mesenterium are reliable.

关 键 词：阑尾炎 阑尾切除术 腹腔镜检查 对比研究 

分 类 号：R656.8[医药卫生—外科学]