免气腹腹腔镜阑尾切除术与传统气腹腹腔镜阑尾切除术治疗老年阑尾炎的效果比较  

Comparison on effects of gasless laparoscopic appendectomy versus traditional pneumoperitoneal laparoscopic appendectomy on elderly patients with appendicitis

作　　者：陈云山[1] 孙鹏程 栗丹丹 Chen Yunshan;Sun Pengcheng;Li Dandan(Department of General Surgery,the Second Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第二附属医院普通外科,南阳473000

出　　处：《中国实用医刊》2022年第12期22-25,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较免气腹腹腔镜阑尾切除术和传统气腹腹腔镜阑尾切除术治疗老年阑尾炎患者的临床效果。方法回顾性分析2016年1月至2020年12月南阳医学高等专科学校第二附属医院收治的63例老年阑尾炎患者的临床资料,将采用传统气腹腹腔镜阑尾切除术治疗的33例患者作为传统组,采用免气腹腹腔镜阑尾切除术治疗的30例患者作为免气腹组。比较两组围术期指标,比较两组注气或悬吊前(T_(0))、注气或悬吊后10 min(T_(1))、气腹或撤除悬吊后5 min(T_(2))血流动力学指标,并比较两组CO_(2)结合率、疼痛程度及并发症发生情况。结果与传统组比较,免气腹组住院天数、肠道康复时间、活动时间短,且术中出血量少(P<0.05);与传统组比较,免气腹组T_(1)、T_(2)时心率、中心静脉压、平均动脉压较低(P<0.05);与传统组比较,免气腹组术后即刻CO_(2)结合率较低,且术后24 h视觉模拟评分法评分较低(P<0.05);免气腹组并发症发生率(10.00%,3/30)与传统组(18.18%,6/30)比较差异未见统计学意义(P>0.05)。结论与传统气腹腹腔镜阑尾切除术比较,老年阑尾炎患者采用免气腹腹腔镜阑尾切除术可进一步改善患者围术期情况,降低CO_(2)结合率,维持血流动力学稳定,并可缓解疼痛,且并发症发生率低。Objective To compare the clinical effects of gasless laparoscopic appendectomy and traditional pneumoperitoneal laparoscopic appendectomy in the treatment of elderly patients with appendicitis.Methods A total of 63 elderly patients with appendicitis treated in the Second Affiliated Hospital of Nanyang Medical College from January 2016 to December 2020 were retrospectively analyzed.Among them,33 patients treated by traditional pneumoperitoneal laparoscopic appendectomy were selected as the traditional group,and 30 patients treated by gasless laparoscopic appendectomy were selected as the gasless group.The perioperative indexes of the two groups were compared,the hemodynamics before gas injection or suspension(T_(0)),10 min after gas injection or suspension(T_(1))and 5 min after removing pneumoperitoneum or suspension(T_(2))were compared between the two groups.And the CO_(2)binding rate,pain degree and complication rate of the two groups were compared.Results Compared with the traditional group,the days of hospitalization,intestinal recovery time and activity time of the gasless group were shorter,and the amount of intraoperative blood loss was less(P<0.05).Compared with the traditional group,the heart rate,central venous pressure and mean arterial pressure in the gasless group at T_(1)and T_(2)were lower(P<0.05).Compared with the traditional group,the immediate postoperative CO_(2)binding rate in the gasless group was lower,and the postoperative visual analogue scale score in the gasless group was lower 24 h after operation(P<0.05).There was no significant difference in the incidence of complications between the gasless group(10.00%,3/30)and the traditional group(18.18%,6/30),P>0.05.Conclusions Compared with traditional pneumoperitoneal laparoscopic appendectomy,gasless laparoscopic appendectomy in the treatment of elderly patients with appendicitis can further improve the perioperative situation,reduce CO_(2)binding rate,maintain hemodynamic stability,relieve pain,with lower incidence of complications.

关 键 词：阑尾炎 免气腹腹腔镜 传统气腹腹腔镜 血流动力学 

分 类 号：R656.8[医药卫生—外科学]