急性化脓性阑尾炎行腹腔镜手术与开腹手术的比较  

Comparison between laparoscopic surgery and open surgery in treatment of patients with acute suppurative appendicitis

作　　者：田宋君[1] 李中明[1] 卢开刚[1] 

机构地区：[1]武汉科技大学附属汉阳医院普外科,湖北武汉430050

出　　处：《临床和实验医学杂志》2011年第19期1507-1509,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨急性化脓性阑尾炎行腹腔镜阑尾切除术(LA)的可行性及疗效。方法对2009年5月至2010年12月收治的125例急性化脓性阑尾炎(术后病检证实为急性蜂窝织炎性阑尾炎)患者,其中56例行LA术,69例开腹阑尾切除术(OA),对LA和OA治疗化脓性阑尾炎的疗效方面进行回顾性综合分析。结果 LA组与OA组在手术操作时间上差异无统计学意义;LA组在切除阑尾的同时可以发现和治疗其他隐性疾病,OA组则无此作用;LA组均未放置引流管;而OA组有42例放置引流管、在术后使用镇痛药、术后下床活动时间、切口感染发生率、住院时间等项中,LA组明显优于OA组;平均住院费用LA组稍高于OA组。结论 LA术后恢复快,创伤小兼有美容效果,不污染手术切口,切口并发症少,是目前阑尾切除术较理想的方法,值得推广。To explore the feasibility and effectiveness of laparoscopic appendectomy （LA） in treatment of patients with acute suppurative appendicitis. Methods One hundred and twenty five patients with acute purulent appendicitis （ post - operative pathological examination confirmed as acute cellular appendicitis） during May 2009 to December 2010 including 56 cases with routine LA and 69 cases with laparotomie appendectomy （ OA）, and the outcomes of LA and OA in treatment of suppurative appendicitis were retrospectively analyzed. Results The difference in operating time of LA group and OA group was statistically significant. Appendectomy in LA group can find and treat other hidden diseases at the same time, but there was no such advantage in OA group. The drainage tube was not necessary to be placed in LA group, but drainage tube had been placed in 42 cases of OA groups. In the use of analgesics, postoperative activity time ; incision infection rate and duration for hospitalization in LA group were obviously superior to those of OA group. Average hospitalization expenses in LA group were just above those of OA group. Conclusion Postoperative recovery in patients of LA group was quicker with both small trauma and cosmetic effect, no contamination to incision and less incision complications. Hence LA is currently an ideal method for appendectomy, and it is worthy to be popularized.

关 键 词：急性化脓性阑尾炎 阑尾切除术腹腔镜术并发症 

分 类 号：R656.8[医药卫生—外科学]