65岁以上急性阑尾炎患者腹腔镜术后并发症的临床研究  

Clinical study on post-operation complications of laparoscopic appendectomy for patients over 65 years old

作　　者：李祖贵 梁先春 LI Zu-gui;LIANG Xian-chun(Department of General Surgery,Xinxin Hospital of Qijiang,Chongqing 401420,China;Department of Hepatobiliary Surgery,Army Medical Center of PLA,Chongqing 400010,China)

机构地区：[1]重庆市綦江区心新医院普外科,重庆401420 [2]解放军陆军特色医学中心肝胆外科,重庆400010

出　　处：《局解手术学杂志》2019年第5期415-417,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的分析65岁以上急性阑尾炎患者经腹腔镜和开腹阑尾切除术后并发症的发生率及治疗策略。方法选取重庆市綦江区心新医院2010年1月至2015年12月收治的65岁以上行急性阑尾炎手术切除患者168例为研究对象。按手术方式分为腹腔镜组(LA组)和开腹手术组(OA组)。比较两种术式手术时间、术中出血量、患者下床活动时间、住院时间和术后并发症发生率。结果 LA组患者的手术时间、术中出血量、下床活动时间、住院时间、切口愈合不良和粘连性肠梗阻的发生率明显少于OA组患者,差异具有统计学意义(P <0. 05)。结论 65岁以上老年急性阑尾炎患者行腹腔镜阑尾切除术并发症发生率较低,恢复快,但术前应准确评估,根据患者情况选择,避免术后发生并发症。Objective To analyze the incidence of postoperative complications and treatment strategies of laparoscopic appendectomy and conventional open appendectomy for patients over 65 years old. Methods A total of 65 patients with acute appendicitis in Xinxin hospital of Qijiang from January 2010 to December 2015 were selected as object,who were divided into laparoscopic appendectomy( LA) group and open appendectomy( OA) group according to surgical methods. The operative time,blood loss,postoperative ambulation time,hospitalization and rate of postoperative complication between two groups were compared. Results The operative time,blood loss,time of post-operative activity out of bed,hospitalization and rate of poor wound healing and adhesive intestinal obstruction in LA group were lower than those in OA group,the differences were significant( P < 0. 05). Conclusion Laparoscopic appendectomy has the advantages of low incidence of complication and rapid recovery for patients with acute appendicitis over 65 years old,therefore,the individualized treatment strategy should be selected according to preoperative evaluation of patients to avoid postoperative complication.

关 键 词：急性阑尾炎 腹腔镜术 开腹手术 老年人 并发症 

分 类 号：R656.8[医药卫生—外科学]