腹腔镜治疗小儿复杂性阑尾炎的临床分析  

Clinical analysis of laparoscopic appendectomy for children complicated appendicitis

作　　者：吕成超[1] 黄河[1] 戚士芹[1] 

机构地区：[1]安徽省立儿童医院儿外科,合肥230051

出　　处：《中华小儿外科杂志》2012年第12期901-904,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的对比分析腹腔镜阑尾切除术（LA）和开腹阑尾切除术（0A）治疗小儿复杂性阑尾炎的疗效。方法回顾性分析2004年5月至2010年12月收治的小儿复杂性阑尾炎1008例的临床资料，比较LA组和OA组手术时间、住院费用、腹腔脓肿及切口感染发生率。结果两组均无手术死亡病例。LA组有24例中转开腹手术，Trocar孔／切口感染发生率（6．1％）较OA组（11．9％）低，差异有统计学意义（P=0．001）。术后腹腔脓肿发生率LA组较OA组高（7．4％vs3．7％），差异有统计学意义（P=0．011）。LA组手术时间较OA组长[（54±12）min vs（53±14）min]，且费用较OA组高[（7305±426）元vs（7255±435）元]，但差异均无统计学意义（P=0．226，P=0．066）。结论LA具有创伤小、恢复快、并发症少、住院时间短等优点，是治疗小儿复杂性阑尾炎安全、有效的手术方式，但术后腹腔脓肿发生率偏高。Objective To compare the therapeutic efficacy of laparoscopic appendectomy （LA） with open appendectomy （OA） in children appendicitis complicated with gangrene, perforation and ab- scess. Methods Total 1008 case of children with appendicitis underwent laparoscopic （LA） （n = 472） and open appendectomy （OA） （n = 536） in our department between 2004 and 2010. The operative time, wound infection, postoperative intra-abdominal abscess and hospital expenses were targeted to evaluate in both groups. Results There was no mortality in both groups. 24 cases of patients in LA group was converted to open procedure and wound （Trocar site） infection rate was significantly lower than that of OA group （6. 1% vs. 1i. 9%, P= 0. 001）. In term of postoperative intra-abdominal ab- scess, the incidence in LA group was higher than OA group （7. 4% vs. 3.7%, P = 0. 011）. Further- more, the operation time in LA group was longer than OA group （54 ± 12 rain vs. 53 ± 14 rain, P = 0. 226）, and the hospital expenses was more expensive in LA group than in OA group （7305± 426 RMB vs 7255 ± 435 RMB, P = 0. 066）. Conclusions Laparoscopic appendectomy is a safe and benefi- cial operative procedure for children with appendicitis. The shorter hospital stay, fast recovery, low incidence of complication rate, as well as better cosmetics can be found in it. However., potential intra- abdominal abscess needs to be prevented.

关 键 词：腹腔镜检查 阑尾切除术 阑尾炎 

分 类 号：R726[医药卫生—儿科]