腹腔镜与开放手术治疗急性穿孔性阑尾炎的对比研究  

Laparoscopic versus open appendectomy in patients with perforated acute appendicitis: a retrospective comparative study

作　　者：沈正海[1] 詹峰[1] 沈振伟[1] 蒋超[1] 张楷[1] 张云[1] SHEN Zheng-hai ZHAN Feng SHEN Zhen-wei et al(Department of Hepatobiliary and Laparoscopic Surgery ,the Affiliated Yixing Hospital of Jiangsu University, Yixing 214200, China)

机构地区：[1]宜兴市人民医院,江苏宜兴214200

出　　处：《腹腔镜外科杂志》2016年第11期858-860,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜手术治疗急性穿孔性阑尾炎的手术效果及临床价值。方法:回顾分析2010年9月至2015年9月收治的253例穿孔性阑尾炎患者的临床资料,其中115例行腹腔镜阑尾切除术(laparoscopic appendectomy,LA),为LA组;138例行开腹阑尾切除术(open appendectomy,OA),为OA组,对比两组手术时间、肠道功能恢复时间、住院时间、切口感染率、腹腔脓肿发生率。结果:两组均无围手术期死亡病例,均无粪漏发生。LA组较OA组手术时间短[(59.07±11.38)min vs.(79.24±13.84)min,P<0.001];肠功能恢复快[(16.77±2.49)h vs.(23.72±3.69)h,P<0.001];住院时间短[(5.78±0.98)d vs.(7.24±1.17)d,P<0.001],切口感染发生率低(2/115 vs.15/138,P=0.004),术后腹腔脓肿发生率两组差异无统计学意义(6/115 vs.5/138,P=0.536)。结论:LA治疗急性穿孔性阑尾炎较传统手术方式具有明显优势,具有临床推广价值。Objective： To evaluate the clinical effect and value of laparoscopic appendectomy（ LA） for the treatment of perforated acute appendicitis. Methods： The clinical data of 253 cases of perforated acute appendicitis undergoing LA or open appendectomy（ OA） were retrospectively analyzed,including 115 cases of LA（ LA group） and 138 cases of OA（ OA group）. The operating time,intestinal function recovery time,hospital stay,incision infection rate and incidence of intra-abdominal abscess were compared between the two groups. Results： No death or fecal leakage occurred in two groups. The operative time was shorter in LA group [（ 59. 07 ±11. 38） min vs.（ 79. 24 ± 13. 84） min,P 〈 0. 001]. The intestinal function recovery time [（ 16. 77 ± 2. 49） h vs.（ 23. 72 ± 3. 69） h,P〈 0. 001] and hospital stay [（ 5. 78 ± 0. 98） d vs.（ 7. 24 ± 1. 17） d,P 〈 0. 001] were significantly shorter in LA group than those in OA group. Compared with the OA group,the incision infection rate was significantly lower in LA group（ 2 /115 vs. 15 /138,P =0. 004）. No difference was found in the incidence of intra-abdominal abscess（ 6 /115 vs. 5 /138,P = 0. 536） between the two groups.Conclusions： LA is superior to OA for the treatment of perforated acute appendicitis and worthy of clinical popularization.

关 键 词：急性穿孔性阑尾炎 阑尾切除术 腹腔镜检查 剖腹术 对比研究 

分 类 号：R656.8[医药卫生—外科学]