荷包缝合包埋阑尾残端在腹腔镜阑尾切除术中的应用效果分析  

Application of purse-string suture in laparoscopic appendectomy

作　　者：王晓东 纪元 张婷婷 于晓亮 Wang Xiaodong;Ji Yuan;Zhang Tingting;Yu Xiaoliang(First Department of General Surgery,People's Hospital of Haiyang City,Haiyang 265100,China)

机构地区：[1]海阳市人民医院普外一科,265100

出　　处：《国际医药卫生导报》2020年第18期2773-2776,共4页International Medicine and Health Guidance News

摘　　要：目的探讨荷包缝合包埋阑尾残端在腹腔镜阑尾切除术中的应用效果。方法选择本院2017年5月至2019年12月收治拟行腹腔镜阑尾切除术治疗的阑尾炎患者90例,按随机数字表法分为A组(45例)和B组(45例)。A组女25例,男20例,年龄(41.21±2.31)岁;急性蜂窝织性阑尾炎14例,急性单纯性阑尾炎3例,急性化脓性阑尾炎14例,急性坏疽性阑尾炎8例,慢性阑尾炎急性发作3例,慢性阑尾炎3例。B组女27例,男18例,年龄(41.29±2.15)岁;急性蜂窝织性阑尾炎13例,急性单纯性阑尾炎4例,急性化脓性阑尾炎15例,急性坏疽性阑尾炎7例,慢性阑尾炎急性发作4例,慢性阑尾炎2例。A组行荷包缝合包埋阑尾残端,B组行Hem-o-lok结扎夹夹闭阑尾残端。比较两组围术期相关指标、免疫功能、并发症发生情况。结果A组手术用时、术后首次肛门通气时间、住院时间分别为(55.48±9.28)min、(2.32±0.84)d、(4.02±1.09)d,B组分别为(40.32±12.96)min、(3.30±1.01)d、(5.78±1.11)d,差异有统计学意义(均P<0.05);两组术中失血量、术后8 h疼痛程度比较,差异无统计学意义(均P>0.05);术后两组CD4+/CD8+、CD3+较术前明显降低,A组CD4+/CD8+、CD3+为(1.05±0.26)、(44.17±6.35)%,高于B组的(0.75±0.32)、(36.68±6.42)%,差异有统计学意义(均P<0.05);A组术后并发症总发生率低于B组,差异具有统计学意义(P<0.05)。结论腹腔镜阑尾切除术中使用荷包缝合包埋阑尾残端虽会延长手术用时,但可减少并发症发生,缩短术后恢复进程,对免疫功能影响较小。Objective To investigate the effect of embedding appendix stump with purse suture in laparoscopic appendectomy.Methods Ninety patients with appendicitis who underwent laparoscopic appendectomy at our hospital from May,2017 to December,2019 were selected.They were divided into group A(45 cases)and group B(45 cases)by random number table method.There were 25 females and 20 males in group A;they were(41.21±2.31)years old;and among them,there were 14 cases of acute cellular appendicitis,3 cases of simple acute appendicitis,14 cases of acute suppurative appendicitis,8 cases of acute gangrene appendicitis,3 cases of acute exacerbation of chronic appendicitis,and 3 cases of chronic appendicitis.There were 27 females and 18 males in group B;they were(41.29±2.15)years old;and among them,there were 13 cases of acute cellular appendicitis,4 cases of simple acute appendicitis,15 cases of acute suppurative appendicitis,and 7 cases of acute gangrene appendicitis,4 cases of acute exacerbation of chronic appendicitis,and 2 cases of chronic appendicitis.Group A underwent purse suture to embed the appendix stumps,and group B used Hem-o-lok ligation clip to clamp the appendix stumps.The perioperative indicators,immune function,and complications were compared between the two groups.Results The operating time,the time for the first postoperative anal ventilation,and the length of hospital stay were(55.48±9.28)min,(2.32±0.84)d,and(4.02±1.09)d in group A,and were(40.32±12.96)min,(3.30±1.01)d,and(5.78±1.11)d in group B,with statistical differences(all P<0.05).There were no statistical differences in blood loss and pain 8 h after surgery between the two groups(both P>0.05).The CD4+/CD8+and CD3+were lower after than before the operation in both groups.After the operation,the CD4+/CD8+and CD3+were(1.05±0.26)and(44.17±6.35)%in group A,and were(0.75±0.32)and(36.68±6.42)%in group B,with statistical differences(both P<0.05).The total incidence of postoperative complications in group A was lower than that in group B,with a statistic

关 键 词：阑尾炎 腹腔镜阑尾切除术 阑尾残端 HEM-O-LOK结扎夹 荷包缝合包埋 

分 类 号：R656.8[医药卫生—外科学]