腹腔镜下阑尾切除术治疗坏疽性阑尾炎  

Laparoscopic appendectomy for gangrenous appendicitis

作　　者：姜海毅[1] 丁红光[1] 常成[1] 田晓卫[1] 衣舜 

机构地区：[1]青岛市市立医院普外科,山东青岛266011

出　　处：《临床普外科电子杂志》2015年第4期15-19,共5页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨腹腔镜下阑尾切除术治疗坏疽性阑尾炎的价值。方法回顾性分析113例坏疽性阑尾炎病人的临床资料,按手术方式分为腹腔镜下阑尾切除组(laparoscopic appendectomy,LA)及开腹阑尾切除组(open appendectomy,OA),分析两组间在一般临床资料、手术时间、腹腔引流管放置、术后疼痛评分(visual analogue scale,VAS)、术后进食时间、术后并发症(切口感染、腹腔脓肿、麻痹性肠梗阻)、住院时间等方面的差异。结果两组间在一般临床资料方面差异无统计学意义(P>0.05)。在腹腔引流管放置、术后24小时疼痛评分(visual analogue scale,VAS)、术后并发症(切口感染、腹腔脓肿、麻痹性肠梗阻)方面差异具有明显统计学意义,LA组明显优于OA组(P<0.05)。手术时间上OA略低于LA组,但两组未显示明显统计学差异(P=0.073)。两组在住院时间方面差异未显示出统计学意义(P=0.057)。结论腹腔镜下阑尾切除术治疗坏疽性阑尾炎与开腹手术相比具有术后并发症低、恢复快的优势,在有经验的医生可安全应用。Objective To discuss the value of laparoscopic appendectomy （ LA ） in the treatment of acute gangrenous appendicitis. Methods The clinical data of 113 patients of gangrenous appendicitis were analysed retrospectively. According to the surgery type, we assigned the patients in two groups, LA group and Open appendectomy （ OA ） group.The data of the general clinical data, operative time, drainage tube placement, visual analogue scale（VAS） score, days to resumption of diet, postoperative complications（incisional infection,abdominal abscess, and paralytic ileus ） and duration of hospital stay were compared between the two groups. Results There was no statistics difference in general clinical data between the two groups （P〉 0.05）. The difference of drainage tube placement, VAS score, postoperative complications （incisional infection,abdominal abscess,and paralytic ileus） in LA group was significantly better than that in OA group （P〈 0.05）. OA group was slightly lower than that of LA group in operative time,but the difference between the two groups was not statistically significant （P= 0.073）. The difference in duration of hospital stay in the two groups did not show statistical significance （P=0.057）. Conclusion Compared with open appendectomy, laparoscopic appendectomy has the advantage of low postoperative complications and quick recovery in the treatment of gangrenous appendicitis and can be used safely in experienced doctors.

关 键 词：腹腔镜下阑尾切除术 复杂性阑尾炎 外科手术 回顾性分析 

分 类 号：R656.8[医药卫生—外科学]