腹腔镜和开腹阑尾切除术治疗阑尾炎比较研究  

Comparison of clinical effect between laparoscopic and open appendectomy for treatment of appendicitis

作　　者：孙康 帅剑锋[1] 梁启新[1] 王炜 汪晓明[1] SUN Kang,SHUAI Jianfeng,LIANG Qixin,WANG Wei,WANG Xiaoming(The First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui Hefei 230031, Chin)

机构地区：[1]安徽中医药大学第一附属医院普外二科,安徽合肥230031

出　　处：《中医药临床杂志》2018年第4期729-731,共3页Clinical Journal of Traditional Chinese Medicine

摘　　要：目的:对比分析腹腔镜阑尾切除术与开腹阑尾切除术在治疗阑尾炎中的效果。方法:阑尾炎患者180例,按手术方式随机分为开放组和腹腔镜组各90例,以手术时间、术中出血量、通气恢复时间、术后12h内使用止痛药例数、住院时间以及并发症发生率作为观察指标,观察比较2组患者治疗效果。结果:LA组的手术时间、术中出血量、通气恢复时间及住院时间均显著少于开放组,差异有统计学意义(P<0.05),但2组患者的术后12h内使用止痛药例数比较差异无明显统计学意义(P>0.05)。LA组肠瘘、切口感染及肺部感染的发生率分别为1.1%、2.2%、2.2%,显著优于开放组的4.4%、11.1%、6.7%,差异存在统计学意义(P<0.05)。但是肠粘连和腹盆腔脓肿的发生率,2组患者相差不明显,差异无统计学意义(P>0.05)。结论:虽然腹腔镜阑尾炎切除术具有创伤小、出血少、疼痛轻、恢复快、并发症少等优点,但是临床上我们需要严格的选择适应症,否则会适得其反,带来更多的隐患。Objective： Comparative analysis of the effect of laparoscopic appendectomy and open appendectomy in the treatment of appendicitis. Methods： 180 patients with appendicitis were randomly divided into open group and laparoscopic group, 90 cases in each group, according to the surgical method. The operative time, intraoperative blood loss, recovery time of ventilation, number of analgesics used within 12 hours after surgery, length of hospital stay, and incidence of complications were used as observation indicators to observe and compare the treatment effects of the two groups of patients. Results： The operative time, intraoperative blood loss, ventilation recovery time and length of stay in the LA group were significantly less than those in the open group. The difference was statistically significant（P〈0.05）.There was no significant difference in the number of analgesics between the two groups within 12 hours after operation（P〈0.05）. The incidence of intestinal fistula, incision infection and pulmonary infection in the LA group was 1.1%, 2.2%,and 2.2%, respectively, which was significantly better than that in the open group（4.4%, 11.1%, and 6.7%）. The difference was statistically significant（P〈0.05）. However, the incidence of intestinal adhesion and abdominal pelvic abscess was not significantly different between the two groups, and the difference was not statistically significant（P〈0.05）.Conclusion： Although laparoscopic appendicitis resection has the advantages of less trauma, less bleeding, less pain,quicker recovery, fewer complications, etc., clinically we need to strictly select indications, otherwise it will be counterproductive and bring more hidden dangers.

关 键 词：腹腔镜 开腹阑尾切除术 阑尾炎 

分 类 号：R269[医药卫生—中西医结合]