腹腔镜阑尾切除术阑尾残端不同处理方法效果比较  

作　　者：蒋佳凯[1] 张盛[1] 

机构地区：[1]江苏省常州市第三人民医院普外科,213000

出　　处：《浙江临床医学》2017年第10期1864-1865,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨腹腔镜阑尾切除术中两种阑尾残端处理方法的临床效果。方法回顾性分析2014年1月至2016年12月因急慢性阑尾炎行腹腔镜阑尾切除术82例，根据术中阑尾残端处理方式的不同分为两组：A组为Hem—Lock夹闭组（50例），B组为结扎＋荷包缝合包埋组（32例），对比两组的手术时间、术中出血量、术后肠道功能恢复时间、术后并发症发生率、手术费用和术后住院时间等情况。结果两组患者手术过程顺利，无中转开腹，术后无严重并发症出现。两组术中出血量，术后肠道功能恢复时间，术后并发症、术后住院时间均无显著性差异（P〉0．05）。荷包包埋组手术时间（65．8±8．2）min，明显长于Hem-Lock组（46．1±5．6）min，差异具有统计学意义（t=12．934，P〈0．01）；荷包包埋组手术费用（4563±176）元较Hem—Lock组（5524±282）元少（t=17．228，P〈0．01）。荷包包埋组术后并发症发生率总体低于Hem—Lock组，但差异无统计学意义（Х^2=0．534，P〉0．05）。结论两种阑尾残端的处理方式均是有效可行的，残端结扎加荷包包埋相对更安全。可根据患者的经济状况、术者操作技巧熟练度及具体术中情况灵活应用。Objective To compare purse-string suture and Hem-o-lock ligation in securing of appendix stump in laparoscopic appendectomy. Methods From June 2010 to June 2013, 82 patients who were diagnosed appendictis underwent laparoscopic appendectomy in our hospital were selected. They were treated with two different methods in securing of the base of the appendix： group A （ Hem-o-lock ligation of the stump ） with 50 cases and group B （ silk ligation of the stump and purse-string suture embedment ） with 32 cases. Operation time, blood bleeding, recovery time of intestine, post-operation hospital stay, operation expense and complication were compared in two groups. Results The operation of two groups were all completed with neither changing to open operation nor severe complications. There was no statistically difference referred to blood bleeding, recovery time of intestine, post-operation hospital stay and complication between the two groups. Group B had longer operation time than group A, while group A had higher operation cost than the group B. Also, silk ligation of the stump and purse-string suture embedment had fewer complications than Hem- o-lock ligation. Conclusion Both of the methods are effective and feasible in securing of the base of the appendix in laparoscopic appendectomy. But using silk ligation of the stump and purse-string suture embedment may be showed advantage in security. Which methods can be chosen depend on the economic condition of patients, the skill proficiency of the operator and the definite situation in the operation.

关 键 词：腹腔镜 阑尾切除术 阑尾残端 

分 类 号：R656.8[医药卫生—外科学]