经脐入路手术治疗小儿阑尾炎的研究  

Study of transumbilical endoscopic surgery in treatment of children with appendicitis

作　　者：谷印堂[1] 汪洋[1] 郝俊[1] 

机构地区：[1]广州医学院附属深圳沙井医院普通外科,广东深圳518000

出　　处：《中国现代医生》2013年第10期145-146,149,共3页China Modern Doctor

基　　金：深圳市宝安区科技计划社会公益项目[2010610(深保科(2010)33号文件)

摘　　要：目的探讨经脐入路手术治疗小儿阑尾炎临床疗效和安全性。方法选择2005年6月～2011年6月我院收治的88例阑尾炎患儿作为研究对象,运用随机数字表法,将符合本研究纳入标准和排除标准的患儿分为A组和B组,A组进行传统开腹阑尾切除术治疗,B组则采用经脐入路手术进行治疗,观察并比较两组患儿手术时间、术中出血量、切口长度、术后肛门排气时间、术后住院时间、术后住院费用和术后并发症发生率。结果 B组切口长度、术中出血量、术后住院时间、术后住院费用、切口感染发生率均明显少/短于A组,差异有统计学意义(P<0.05)。手术时间和术后肛门排气时间两组无显著差异(P>0.05)。结论经脐入路手术治疗小儿急性阑尾炎临床疗效确切、安全,具有术中出血量少、术后住院时间短、术后住院费用少、并发症少和切口美观等特点,优于传统开腹阑尾切除术,适用于发病时间短(<48 h)、无弥漫性腹膜炎、非肥胖患儿,值得进一步推广,尤其适合基层医院。Objective To investigate the clinical efficacy and safety of transumbilical endoscopic surgery in the treatment of children with appendicitis.Methods Eighty-eight children with appendicitis admitted to our hospital from June 2005 to June 2011 were selected as the study group and children meeting the inclusion criteria and the exclusion criteria were divided into group A and group B respectively according to the random number table.Group A received conventional open appendectomy while group B received transumbilical endoscopic surgery.The operative time,intraoperative blood loss,incision length,postoperative anal exhaust time,postoperative hospital stay,postoperative hospital costs and postoperative complication rate of the two groups were observed and compared.Results Group B was significantly less/shorter than group A in the incision length,intraoperative blood loss,postoperative hospital stay,postoperative hospitalization costs and incision infection rate,with significant differences（P 0.05）.The two groups were not significantly different in the operative time and postoperative anal exhaust time（P 0.05）.Conclusion Transumbilical endoscopic surgery shows exact clinical efficacy and safety in the treatment of patients with appendicitis,having the characteristics of less blood loss,shorter postoperative hospital stay,less postoperative cost,fewer complications and beautiful incision,which is superior to the traditional open appendectomy and suitable for children having onset of 48 hours,without diffuse peritonitis and without obesity,thereby worthy of further promotion,especially for primary hospitals.

关 键 词：经脐入路手术 传统开腹阑尾切除术 急性阑尾炎 

分 类 号：R726.5[医药卫生—儿科]