经腹壁悬吊阑尾法在急性化脓性阑尾炎和阑尾周围脓肿腹腔镜阑尾切除术中的效果观察  

The effect of transabdominal wall suspended laparoscopic appendectomy for acute suppurative appendicitis and periappendiceal abscess

作　　者：胡振涛 吴延花 花亚军 Hu Zhentao;Wu Yanhua;Hua Yajun(Department of General Surgery,Hexi University,Zhangye People's Hospital,Zhangye 734000,China)

机构地区：[1]河西学院附属张掖人民医院普外科,张掖734000

出　　处：《中国医师进修杂志》2024年第7期636-640,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价经腹壁悬吊阑尾法在急性化脓性阑尾炎和阑尾周围脓肿患者腹腔镜阑尾切除术(LA)中的应用价值。方法回顾性分析河西学院附属张掖人民医院2019年9月至2022年12月107例急性化脓性阑尾炎或合并阑尾周围脓肿患者的临床资料。其中,行开腹阑尾切除术(OA)53例(OA组),经腹壁悬吊阑尾法LA 54例(LA组)。比较两组手术时间、术后切口疼痛评分、术后住院时间、胃肠道功能恢复时间、术后并发症和住院费用。结果LA组术中2例因腹腔粘连较重、解剖不清而中转开腹;3例因阑尾根部穿孔或阑尾坏疽无法悬吊。两组手术时间比较差异无统计学意义(P>0.05);LA组术后住院时间、肠道功能恢复时间、术后切口疼痛评分和总并发症发生率明显低于OA组[(4.92±1.70)d比(7.51±3.96)d、(20.64±7.37)h比(35.32±10.13)h、(5.62±1.12)分比(6.83±0.93)分和5.56%(3/54)比24.53%(13/53)],住院费用明显高于OA组[(8325.47±856.22)元比(6458.64±2085.93)元],差异有统计学意义(P<0.05)。结论采用经腹壁悬吊阑尾法行LA具有适应证广、操作简便易行、创伤小、恢复快、并发症少等优点,但住院费用较高。ObjectiveTo evaluate the application value of transabdominal wall suspended laparoscopic appendectomy(LA)in patients with acute suppurative appendicitis or concurrent periappendiceal abscess.MethodsThe clinical data of 107 patients with acute suppurative appendicitis or concurrent periappendiceal abscess in Hexi University,Zhangye People′s Hospital from September 2019 to December 2022 were retrospectively analyzed.Among them,53 patients underwent open appendectomy(OA)(OA group),and 54 patients underwent transabdominal wall suspended LA(LA group).The operation time,postoperative pain score,postoperative hospitalization time,recovery time of gastrointestinal function,postoperative complications and hospital cost were compared between two groups.ResultsIn the LA group,2 cases were transferred to OA due to heavy abdominal adhesion and unclear anatomy,and 3 cases could not undergo transabdominal wall suspended LA due to perforation of the root of the appendix or gangrene of the appendix.There was no statistical difference in operation time between two groups(P>0.05);the postoperative hospitalization time,recovery time of gastrointestinal function,postoperative pain score and total incidence of postoperative complications in LA group were significantly lower than those in OA group:(4.92±1.70)d vs.(7.51±3.96)d,(20.64±7.37)h vs.(35.32±10.13)h,(5.62±1.12)scores vs.(6.83±0.93)scores and 5.56%(3/54)vs.24.53%(13/53),the hospital cost was significantly higher than that in OA group:(8325.47±856.22)yuan vs.(6458.64±2085.93)yuan,and there were statistical differences(P<0.05).ConclusionsTransabdominal wall suspended LA has the advantages of wide indications,easy operation,minimal trauma,fast recovery,and fewer complications,but with relatively high hospitalization cost.

关 键 词：阑尾炎 阑尾切除术 腹腔镜 对比研究 

分 类 号：R656.8[医药卫生—外科学]