腹腔镜阑尾切除术与开腹阑尾切除术治疗急性阑尾炎的疗效比较  

Comparison of Effect Between Laparoscopic Appendectomy and Open Appendectomy for Acute Appendicitis

作　　者：蒋安科[1] 周庆[1] 李强[1] 李博[1] 鄢传经[2] 

机构地区：[1]成都医学院第一附属医院肝胆外科,四川成都610500 [2]成都医学院第一附属医院胃肠外科,四川成都610500

出　　处：《现代生物医学进展》2015年第24期4710-4712,4715,共4页Progress in Modern Biomedicine

摘　　要：目的:比较腹腔镜阑尾切除术和开腹阑尾切除术治疗急性阑尾炎的临床疗效。方法:选取2012年3月-2014年3月我院收治的急性阑尾炎患者127例,按照随机数字表法分为两组,观察组63例行腹腔镜阑尾切除手术,对照组64例行开腹阑尾切除手术,比较两组的手术效果及术后并发症情况。结果:两组的手术时间差异无统计学意义(P>0.05),观察组术中出血量、肛门排气时间及住院时间均低于对照组,差异有统计学意义(P<0.05)。两组治疗后VAS评分较治疗前有不同程度的降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组切口感染、肠梗阻以及腹腔脓肿发生率均低于对照组,差异有统计学意义(P<0.05),而两组腹腔内出血、阑尾残端瘘的发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜阑尾切除术治疗急性阑尾炎具有手术效果好、预后快及术后并发症少等特点,值得临床推广使用。Objective： To compare the clinical effect between laparoscopic appendectomy and open appendectomy in the treatment of acute appendicitis. Methods： A total of 127 patients with acute appendicitis, who were admitted to First Affiliated Hospital of Chengdu Medical College from March 2012 to March 2014, were randomly divided into observation group（n=63） and control group（n=64）. The observation group was received laparoscopic appendectomy, while the control group, open appendectomy. And then the operation effect and postoperative complication were compared between the two groups. Results： There was no statistical significance in the operation time between the two groups（P〉0.05）; compared with the control group, the amount of bleeding, anal exhaust time and hospitalization time of observation group were less, the difference was statistically significant（P〈0.05）. The VAS scores of two groups after treatment were lower to different extent than those before treatment, and the observation group was less than the control group, the difference was statistically significant（P〈0.05）. The wound infection, intestinal obstruction and intra-abdominal abscess incidence of observation group were lower than those of control group, the difference was statistically significant（P〈0.05）; but there was no statistical significance in the intraperitoneal hemorrhage and appendiceal stump fistula incidence rate between the two groups（P〉0.05）. Conclusion： The laparoscopic appendectomy in the treatment of acute appendicitis has the advantages of better operation effect, fast prognosis and less postoperative complication, which is worthy of clinical application.

关 键 词：急性阑尾炎 腹腔镜阑尾切除术 开腹阑尾切除术 手术效果 

分 类 号：R656.8[医药卫生—外科学]