老年急性阑尾炎行腹腔镜与开腹手术的对比分析

Comparative study of laparoscopic appendectomy and operation appendectomy in aged patients with acute appendicitis

目的对比分析腹腔镜(LA)和开腹阑尾切除术(OA)治疗老年急性阑尾炎的手术效果。方法2003年1月至2006年1月行阑尾切除术治疗老年阑尾炎56例,其中LA27例,OA29例。比较2种术式的手术时间、下床活动时间、术后排气时间、疼痛评分、误诊率、止痛药使用率、切口感染率、置管引流率、残余脓肿发生率、住院时间和综合费用。结果LA组和OA组以上各指标(除手术时间和综合费用外)差异均有统计学意义(P<0.05)。结论对于老年急性阑尾炎,和OA相比,LA具有创伤小、恢复快、并发症少和平均住院时间短等优点,值得临床推广。

Objective To compare and evaluate the effect of laparoscopic appendectomy （LA） and operation appendectomy （OA） on aged patients with acute appendicitis. Methods From January 2003 to January 2006, 56 aged patients with acute appendicitis were operated on. Among them,27 were treated with LA and 29 with OA. The operation time, recovery period, bowel exhaust time, pain scale, erroneous diagnosis rate, anesthetic usage rate, wound infection rate, drainage rate, residual abscess, the hospitalizing days and the cost were analyzed. Results There were significant differences between LA and OA in these indexes except the operation time and the cost for hospitalizing （ P 〈 0. 05 ）. Conclusions Compared with OA, LA is a more popular choice for elderly patients with acute appendicitis because of its advantages of minimal invasion ,early recovery, few complications and hospitalization time.