老年复杂性阑尾炎行腹腔镜阑尾切除术的疗效及安全性分析  

Curative Effect and Safety Analysis of Laparoscopic Appendectomy for Elderly Patients with Complicated Appendicitis

作　　者：孙康[1] 郭建 瞿建国[1] 范昕[1] 谢嵘[1] 陈吉祥[1] SUN Kang;GUO Jian;QU Jianguo;FAN Xin;XIE Rong;CHEN Jixiang(The Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院,江苏镇江212001

出　　处：《中国医学创新》2020年第3期132-136,共5页Medical Innovation of China

基　　金：镇江市重点研发计划(社会发展)项目(SH2018082)。

摘　　要：目的:分析老年复杂性阑尾炎行腹腔镜阑尾切除术疗效及安全性。方法:回顾性分析本院2012年1月-2018年6月收治的116例老年复杂性阑尾炎患者的临床资料,根据手术方式的不同分为LA组(n=64)和OA组(n=52)。比较两组在手术时间、术后胃肠功能恢复时间、术后下床活动时间、疼痛评分、住院时间、住院费用以及术后并发症等方面的差异。结果:两组手术时间比较,差异无统计学意义(P>0.05);LA组术后胃肠功能恢复时间、下床活动时间、住院时间均短于OA组(P<0.01);LA组术后24 h疼痛评分低于OA组(P<0.01);LA组住院费用明显高于OA组(P<0.01)。LA组切口感染、腹腔脓肿、肠梗阻发生率均低于OA组(P<0.05);两组粪瘘、出血发生率比较,差异均无统计学意义(P>0.05);LA组并发症总发生率为3.1%,低于OA组的40.4%(P<0.01)。结论:腹腔镜阑尾切除术治疗老年复杂性阑尾炎,具有胃肠功能恢复快、并发症少和住院时间短等优点,具有更好的疗效及安全性。Objective:To analyze the efficacy and safety of laparoscopic appendectomy for senile complicated appendicitis.Method:The clinical data of 116 elderly patients with complicated appendicitis admitted to our hospital from January 2012 to June 2018 were analyzed retrospectively.According to different surgical methods,they were divided into LA group (n=64) and OA group (n=52).The differences between the two groups were compared in operation time,postoperative recovery time of gastrointestinal function,postoperative out-of-bed activity time,pain score,hospitalization time,hospitalization cost and postoperative complications.Result:There was no significant difference in operation time between the two groups (P>0.05).The postoperative recovery time of gastrointestinal function,out-of-bed activity time and hospitalization time in the LA group were shorter than those in the OA group (P<0.01).The pain score at 24 h after surgery of LA group was lower than that of OA group (P<0.01).The hospitalization cost in LA group was significantly higher than that in OA group (P<0.01).The incidence of incision infection,abdominal abscess and intestinal obstruction in LA group were lower than those in OA group,the differences were statistically significant (P<0.05).The incidence of fecal fistula and bleeding in the two groups were compared,the differences were not statistically significant (P>0.05).The overall incidence of complications in the LA group was 3.1%,lower than 40.4% of the OA group (P<0.01).Conclusion:Laparoscopic appendectomy for the treatment of senile complicated appendicitis has the advantages of fast recovery of gastrointestinal function,less complications and short hospital stay,has better efficacy and safety.

关 键 词：腹腔镜 阑尾切除术 老年患者 复杂性阑尾炎 

分 类 号：R656.8[医药卫生—外科学]