腹腔镜系膜剥离法阑尾切除术与腹腔镜常规阑尾切除术的对比研究  

Comparison of mesoappendix dissection in laparoscopic appendectomy and conventional laparoscopic appendectomy

作　　者：张育瑆[1] 赵惠斌 张朝军[1] ZHANG Yu-xing;ZHAO Hui-bin;ZHANG Chao-jun(Department of General Surgery,Navy General Hospital,Beijing 100048,China)

机构地区：[1]海军总医院普通外科,北京100048

出　　处：《局解手术学杂志》2018年第8期550-553,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：北京市自然科学基金(7174355)

摘　　要：目的比较阑尾炎患者腹腔镜系膜剥离法阑尾切除术及腹腔镜常规阑尾切除术的临床疗效。方法选取2016年3月至2017年2月在海军总医院就诊的急性阑尾炎或慢性阑尾炎急性发作患者200例,将其随机分观察组和对照组,每组100例。观察组行腹腔镜系膜剥离法阑尾切除术,对照组行腹腔镜常规阑尾切除术,比较2组患者手术时间、活动性出血发生率、标本从Trocar中取出率、术后盆腔感染例数、术后穿刺口感染例数及术后平均住院时间。结果观察组手术时间短于对照组,活动性出血发生率低于对照组,标本从Trocar中取出率高于对照组,2组比较差异有统计学意义(P<0.05);2组患者术后盆腔感染率、穿刺口感染率及术后平均住院时间比较差异无统计学意义(P>0.05)。结论使用系膜剥离法行腹腔镜阑尾切除术,虽未显著降低术后感染率及术后住院时间,但有效减少了手术时间及术中出血,较常规的腹腔镜阑尾切除术具有明显的优势。Objective To investigate the short-term curative effect of mesoappendix dissection and conventional laparoscopic appendectomy for appendicitis patients. Methods A total of 200 patients with acute appendicitis or acute episode of chronic appendicitis admitted in navy general hospital from March 2016 and February 2017 were randomly divided into observation group and control group,100 cases in each group.The observation group were treated with mesoappendix dissection in laparoscopic appendectomy,and the control group received conventional laparoscopic appendectomy.The operation duration,the active bleeding incidence,the ratio of taking out specimen from trocar,the time of hospitalization after operation and the incidence of pelvic infection and puncture infection were compared between two groups. Results The operation duration in observation group was shorter than that in control group,the active bleeding incidence in observation group was lower than that in control group,and the ratio of taking out specimen from trocar in observation group was higher than that in control group,the differences were significant（ P 〈0.05）.There was no significant difference in the ratio of pelvic infection,puncture infection and the time of hospitalization after operation between two group（ P 〉0.05）. Conclusion Although mesoappendix dissection laparoscopic appendectomy cannot reduce the chance of infection or shorten the period of hospitalization,but it can shorten operation time and reduce bleeding during operation effectively.So the modified operation method has more advantages than the conventional one in acute appendicitis and acute episode of chronic appendicitis.

关 键 词：阑尾炎 腹腔镜阑尾切除术 近期疗效 改良术式 

分 类 号：R656.8[医药卫生—外科学]