自制入路通道经脐单孔腹腔镜手术治疗非创伤性急腹症的疗效分析  

Effect analysis of transumbilical laparoscopic single-site surgery with self-made channel for non-traumatic acute abdomen

作　　者：陈龙 徐华 CHEN Long;XU Hua(Department of General Surgery,Guangdong Provincial People's Hospital Zhuhai Hospital,Zhuhai Golden Bay Center Hospital,Zhuhai 519041,China)

机构地区：[1]广东省人民医院珠海医院,珠海市金湾中心医院普通外科,广东珠海519041

出　　处：《腹腔镜外科杂志》2022年第6期454-458,共5页Journal of Laparoscopic Surgery

基　　金：珠海市医学科研基金项目(ZH24013310210058PWC)。

摘　　要：目的:探讨采用自制入路通道行经脐单孔腹腔镜手术治疗非创伤性急腹症的临床价值。方法:回顾分析2020年6月至2021年6月收治的360例60岁以下非创伤性急腹症患者的临床资料,包括急性阑尾炎(A组,n=120)、急性胆囊炎(B组,n=120)、急性上消化道穿孔(C组,n=120),其中观察组采用自制入路通道行经脐单孔腹腔镜手术(A1组、B1组、C1组,每组60例),对照组行常规腹腔镜手术(A2组、B2组、C2组,每组60例),对比分析各组手术结果。结果:各组手术时间、失血量差异无统计学意义(P>0.05);观察组住院费用均低于对照组,术后排气时间、术后进食时间、卧床时间、住院时间均短于对照组(P<0.05),手术并发症发生率低于对照组(P<0.05)。术前各组疼痛评分差异无统计学意义(P>0.05);术后第1天、第2天、第3天,观察组疼痛评分均低于对照组(P<0.05),切口美容满意度高于对照组(P<0.05)。结论:自制入路通道经脐单孔腹腔镜手术治疗非创伤性急腹症效果显著,可缩短住院时间,减少并发症,缓解疼痛,有助于病情的快速康复。Objective:To study the clinical value of transumbilical laparoscopic single-site surgery with self-made channel in the treatment of non-traumatic acute abdomen.Methods:Three hundred and sixty patients with non-traumatic acute abdomen under 60 years of age treated from Jun.2020 to Jun.2021 were retrospectively analyzed,including 120 acute appendicitis patients(group A),120 acute cholecystitis cases(group B)and 120 acute gastrointestinal perforation cases(group C).Patients were assigned to observation group(transumbilical laparoscopic single-site surgery with self-made channel,group A1,group B1 and group C1 with 60 cases in each group)and control group(conventional laparoscopic surgery,group A2,group B2 and group C2 with 60 cases in each group).Operation results were comparatively analyzed.Results:The operation time and blood loss among groups showed no statistically significant difference(P>0.05);The hospitalization expenses in group A1,group B1 and group C1 were lower than those in group A2,group B2 and group C2;the postoperative exhaust time,feeding time,bedridden time and hospital stay were shorter than those of group A2,group B2 and group C2(P<0.05).The complication rates in observation group were lower than those of control group(P<0.05).Before operation,pain scores among groups showed no statistically significant difference(P>0.05).On the first,second and third day after operation,pain scores in observation group were lower than those in control group(P<0.05).The clinical satisfaction about the incisional cosmetic results in observation group was higher than that in control group(P<0.05).Conclusions:The transumbilical laparoscopic single-site surgery with self-made channel can remarkably increase the treatment effects of non-traumatic acute abdomen,shorten hospital stay,reduce complications,relieve pain and promote fast rehabilitation.

关 键 词：急腹症 腹腔镜检查 单孔 经脐 自制通道 

分 类 号：R656.1[医药卫生—急诊医学]