腹腔镜阑尾切除术治疗腹部手术史急性阑尾炎的临床研究  

Clinical study on laparoscopic appendectomy for acute appendicitis with previous abdominal surgery

作　　者：黎朝良[1] 方兰[2] 黄建朋[1] 董荣坤[1] 韩明福[1] 

机构地区：[1]湖北医药学院附属人民医院胃肠外科,十堰442000 [2]湖北医药学院附属人民医院消化内科科,十堰442000

出　　处：《国际外科学杂志》2013年第7期447-450,共4页International Journal of Surgery

摘　　要：目的探讨腹腔镜阑尾切除术治疗腹部手术史急性阑尾炎的的可行性及临床疗效。方法回顾性分析2009年2月-2012年6月行腹腔镜手术治疗的253例急性阑尾炎患者的临床资料，其中无腹部手术史患者177例（无手术史组），腹部手术史患者76例（手术史组），比较两组患者的中转开腹率、手术时间、术中失血量、肠功能恢复时间、并发症发生率、术后住院时间。结果无手术史组和手术史组的中转开腹率分别是1．7％和1．3％（P〉0．05），手术时间分别是（40．5±12．3）min和（62．6±14．2）min（P〈0．05）。两组的术中失血量、肠功能恢复时间、术后并发症发生率及术后住院时间的差异均无统计学意义（P〉0．05）。结论腹部手术史使腹腔镜阑尾切除术的手术时间延长，但对手术疗效无明显影响，提示腹腔镜手术治疗腹部手术史急性阑尾炎安全、有效，且仍具有创伤小、恢复快的优势。Objective To evaluate the feasibility, safety and efficacy of laparoscopic appendectomy for acute ap- pendicitis with previous abdominal surgery. Methods The clinical data of 253 patients with acute appendicitis un- dergoing laparoscopic surgery was retrospectively studied from Feb. 2009 to Jun. 2012, including 177 patients without previous abdominal surgery （no previous abdominal surgery group, NPAS group ）, 76 patients with previous abdomi- nal surgery （previous abdominal surgery group, PAS group ）. Parameters studied were conversion rates, operation time, blood loss, complications rate, length of hospital stay and the intestine function recovery time between two groups. Results The conversion rates were no significant difference between NPAS group and PAS group. The oper-ation time of NPAS group and PAS group was （40.5 ± 12.3 ） minutes and （62.6 ± 14.2） minutes （ P 〈 0.05 ）. The blood loss, intestine function recovery time, complications rate, and length of hospital stay were no significant minutes between NPAS group and PAS group after operation（P 〉 0.05 ）. Conclusions Previous abdominal surgery prolongs the operation time of laparoscopic appendectomy, but history of abdominal surgery has no significant effect on laparo- scopic surgical outcome, which may indicate that laparoscopic surgery for acute appendicitis with previous abdominal surgery is safe and effective and still has the adventages of less trauma, faster recovery.

关 键 词：腹部手术史 腹腔镜阑尾切除术 急性阑尾炎 

分 类 号：R656.8[医药卫生—外科学]