腹腔镜技术治疗复杂急性阑尾炎的临床体会  

Clinical experience of laparoscopic treatment of complex acute appendicitis

作　　者：陈志新 杨訸泉 刘振玉[1] 郑林辉[1] CHEN Zhixin;YANG Hequan;LIU Zhenyu;ZHENG Linhui(Department of Emergency Surgery,The First Affiliated Hospital of Nanchang University,Jiangxi,Nanchang,330000,China)

机构地区：[1]南昌大学第一附属医院急诊外科,南昌330000

出　　处：《江西医药》2023年第12期1390-1393,共4页Jiangxi Medical Journal

基　　金：江西省教育厅计划基金资助项目,编号GJJ2200144。

摘　　要：目的探讨腹腔镜技术治疗复杂急性阑尾炎的临床疗效,总结相关治疗体会。方法回顾分析2020年9月至2021年12月采用腹腔镜手术治疗的复杂急性阑尾炎患者的临床资料,患者以腹痛、腹胀、发热等为主要临床表现,根据术前体格检查、检验、腹部彩超、诊断性腹腔穿刺、或腹部CT以及术中所见确诊为复杂急性阑尾炎,观察并随访手术及术后恢复情况,另结合临床将复杂急性阑尾炎概括为多种类型,回顾术中相关操作并总结治疗体会。结果共有134例复杂急性阑尾炎患者,均在腹腔镜下手术切除,无一例中转开腹,手术时间40~225 min、平均95.7 min,术中出血5~300 mL、平均36.0 mL,术后住院时间3~9 d、平均4.7 d;患者均顺利出院,住院期间无腹腔出血、阑尾残端瘘、切口化脓感染等并发症发生,术后随访未见切口愈合不良、阑尾残株炎、机械性肠梗阻等并发症患者。结论腹腔镜技术治疗复杂急性阑尾炎安全、有效,具有微创手术优点,患者术后疗效满意,有较高临床应用价值,但术者应具有一定腹腔镜手术经验。Objective To explore clinical effect of laparoscopic technique in the treatment of complex acute appendicitis and summarize the experience of treatment.Methods Clinical data of patients with complex acute appendicitis treated by laparoscopic surgery from September 2020 to December 2021 were reviewed and analyzed.Patients with abdominal pain,abdominal distension,fever and other major clinical manifestations were diagnosed as complex acute appendicitis according to preoperative physical examination,examination,abdominal color ultrasound,diagnostic abdominal puncture,or abdominal CT and intraoperative findings.The operation and postoperative recovery were observed and followed up,and the relevant treatment experience was summarized.Combined with the clinic,complex acute appendicitis was summarized into a variety of types,to review the key procedure of operation during the surgical procedure and summarize the experience of treatment.Results There were a total of 134 patients with complex acute appendicitis,all of which were surgically resected under laparoscope,none of which was converted to laparotomy.The operative time was 40~225 min with an average of 95.7 min,intraoperative bleeding was 5~300 mL with an average of 36.0 mL,and the postoperative hospital stay was 3~9 d with an average of 4.7 d.All patients were discharged successfully,and no complications such as abdominal bleeding,appendiceal stump fistula,and incision suppurative infection occurred during hospitalization.No complications such as poor incision healing,appendiceal stump inflammation,and Mechanical intestinal obstruction were observed during postoperative follow-up.Conclusion Laparoscopic technique is safe and effective in the treatment of complex acute appendicitis,with the advantages of minimally invasive surgery.The postoperative efficacy of patients is satisfactory,and it has high clinical application value.However,the operator should have certain experience basis of laparoscopic surgery,be familiar with the configuration facilities of laparosco

关 键 词：复杂急性阑尾炎 阑尾切除术 腹腔镜检查 

分 类 号：R656.8[医药卫生—外科学]