腹腔镜下阑尾切除术中两种阑尾残端处理方式的效果比较  

Comparison of Two Appendiceal Stump Closure Methods in Laparoscopic Appendectomy

作　　者：陈政 张振 冯伟 左续珍 孟凡来 韩诗卉 石鑫 林斌 CHEN Zheng;ZHANG Zhen;FENG Wei;ZUO Xu-zhen;MENG Fan-lai;HAN Shi-hui;SHI Xin;LIN Bin(Department of General Surgery,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,China;Department of Anesthesiology,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,China;Department of Pathology,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,China)

机构地区：[1]徐州医科大学附属宿迁医院普外科,江苏宿迁223800 [2]徐州医科大学附属宿迁医院麻醉科,江苏宿迁223800 [3]徐州医科大学附属宿迁医院病理科,江苏宿迁223800

出　　处：《实用临床医学（江西）》2019年第8期34-36,I0001,共4页Practical Clinical Medicine

基　　金：宿迁市科技支撑计划项目(S201618)

摘　　要：目的探讨微乔线缝合法和Endoloop套扎法在腹腔镜下阑尾切除术(LA)中的应用效果。方法将126例行LA手术患者根据术中阑尾残端处理的方式分为缝合组(n=65)和套扎组(n=61)。缝合组术中于阑尾根部行丝线结扎后,行荷包缝合法包埋残端。套扎组术中采用Endoloop套扎法处理阑尾残端。观察2组手术时间、住院时间、住院费用和手术成功率、并发症(包括腹盆腔脓肿、右下腹戳孔感染、残端瘘等)发生率。结果2组均无中转开腹病例。缝合组手术时间长于套扎组(P<0.05),2组住院时间、住院费用比较差异无统计学意义(P>0.05)。缝合组手术成功率高于套扎组(100.0%比90.0%,P<0.05)。2组均无腹盆腔脓肿、残端瘘发生。缝合组右下腹戳孔感染发生率与套扎组比较差异无统计学意义(4.6%比3.3%,P>0.05)。结论LA手术患者采用微乔线缝合法和Endoloop套扎法处理阑尾残端各有优缺点,但缝合法更有优势。Objective To compare the efficacies of vicryl suture and endoloop ligation for appendiceal stump closure in laparoscopic appendectomy(LA).Methods A total of 126 patients undergoing LA were assigned to receive either appendix root ligation and purse string suture(vicryl suture group,n=65)or endoloop ligation(endoloop ligation group,n=61)for appendiceal stump closure.Operation time,hospital stay,hospitalization costs,surgical success rate and complications(abdominal pelvic abscess,right lower quadrant puncture infection,stump fistula,etc.)were observed.Results None patients were converted to open surgery and had abdominal pelvic abscess and stump fistula in both groups.The operation time in vicryl suture group was longer than that in endoloop ligation group(P<0.05).However,the operative success rate in vicryl suture group was higher than that in endoloop ligation group(100.0% vs 90.0%,P<0.05).There were no significant differences in hospital stay,hospitalization costs and incidence of right lower quadrant puncture infection between the two groups(4.6% vs 3.3%)(P>0.05).Conclusion Although both have their respective advantages,vicryl suture is more advantageous than endoloop ligation for appendiceal stump closure in patients undergoing LA.

关 键 词：阑尾炎 腹腔镜 阑尾切除术 残端处理 微乔线皮内缝合法 Endoloop套扎法 

分 类 号：R656.8[医药卫生—外科学]