系膜剥离联合推结器打结在腹腔镜阑尾切除术中的应用  

Application of Tethering Stripping Combined with Knot Pusher Knotting in Laparoscopic Appendectomy

作　　者：程强 郭东来 蔡哲臻 潘梓荣 CHENG Qiang;GUO Donglai;CAI Zhezhen;PAN Zirong(Department of General Surgery,Haicang Hospital Affiliated to Xiamen Medical College,Xiamen,Fujian Province,361000 China)

机构地区：[1]厦门医学院附属海沧医院普外科,福建厦门361000

出　　处：《中外医疗》2023年第25期1-4,38,共5页China & Foreign Medical Treatment

基　　金：2022年度厦门市自然科学基金项目(3502Z20227427)。

摘　　要：目的比较阑尾炎患者腹腔镜系膜剥离联合推结器打结法阑尾切除术及腹腔镜常规阑尾切除术的临床疗效。方法回顾性分析2020年6月—2022年6月厦门医学院附属海沧医院50例行腹腔镜下系膜剥离联合推结器打结法阑尾切除术的急性阑尾炎患者的临床资料,并随机抽取同期50例常规腹腔镜下阑尾切除术的急性阑尾炎患者作为对照,比较2组患者主操作孔使用5 mmTrocar次数、术中活动性出血发生率、标本从Trocar中取出率、手术时间、术后并发症(腹腔感染、穿刺口感染、肠梗阻等)例数、住院天数、住院总费用。结果观察组主操作孔使用5 mmTrocar次数高于对照组(42次vs 0次),活动性出血发生率低于对照组(2%vs 16%),标本从Trocar中取出率高于对照组(84%vs 10%),手术时间短于对照组[(36.94±8.18)min vs(49.36±14.78)min],住院总费用低于对照组[(8798.64±808.11)元vs(10075.04±771.69)元],差异有统计学意义(χ^(2)=69.01、4.40、54.96,t=-5.200、-0.808,P<0.05);观察组术后并发症例数低于对照组[3例vs 6例]及住院天数低于对照组[(5.46±1.33)d vs(6.10±2.22)d],但差异无统计学意义(P>0.05)。结论观察组使用系膜剥离联合推结器打结法行腹腔镜阑尾切除术,虽未显著降低术后并发症及住院天数,但在减少了住院总费用、手术时间及术中活动性出血较对照组具有明显优势。Objective To compare the clinical efficacy of laparoscopic tethering stripping combined with knot pusher knotting method of appendectomy and laparoscopic conventional appendectomy in patients with appendicitis.Methods The clinical data of 50 cases of acute appendicitis patients who underwent laparoscopic tethering stripping combined with knot pusher knotting appendectomy in Haicang Hospital Affiliated to Xiamen Medical College from June 2020 to June 2022 were retrospectively analyzed,and 50 cases of conventional appendectomy in the same period were randomly selected.And 50 patients with acute appendicitis who underwent conventional laparoscopic appendectomy in the same period were randomly selected as controls.The number of times 5mm Trocar was used in the main operation hole,the incidence of intraoperative active bleeding,the rate of specimen removal from the Trocar,the operation time,the number of postoperative complications(abdominal infection,puncture wound infection,intestinal obstruction,etc.),the number of days of hospitalization,and the total cost of hospitalization between the two groups were compared.Results In the observation group,the number of times the 5 mm Trocar was used in the main operation hole was higher than that in the control group(42 times vs 0 times),the incidence of active bleeding was lower than that in the control group[2%vs 16%],the rate of specimen removal from the Trocar was higher than that in the control group(84%vs 10%),and the operative time was shorter than that in the control group[(36.94±8.18)min vs(49.36±14.78)min],and the total hospitalization cost was lower than that of the control group[(8798.64±808.11)yuan vs(10075.04±771.69)yuan],and the difference was statistically significant(χ^(2)=69.01,4.40,54.96,t=-5.200,-0.808,P<0.05).The number of postoperative complications in the observation group was lower than that in the control group[3 cases vs 6 cases]and the number of days of hospitalization was lower than that in the control group[(5.46±1.33)days vs(6.10±2.22)days

关 键 词：阑尾炎 腹腔镜阑尾切除术 系膜剥离 推结器打结法 

分 类 号：R656.8[医药卫生—外科学]