急性穿孔性阑尾炎行腹腔镜与开腹手术的疗效对比研究

Comparative study of laparoscopic appendectomy and open appendectomy in acute perforative appendicitis

目的探讨腹腔镜阑尾切除术治疗急性穿孔性阑尾炎的可行性及疗效。方法回顾性分析腹腔镜或开腹阑尾切除术治疗急性穿孔性阑尾炎112例,其中腹腔镜阑尾切除术73例(腹腔镜组),开腹阑尾切除术39例(开腹组)。比较两种术式的手术时间、下床活动时间、术后排气时间、体温恢复正常时间、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、术后肠梗阻、综合费用。结果腹腔镜组和开腹组以上各指标(除手术时间、残余脓肿发生率和综合费用外)差异均有显著性(P<0.05),腹腔镜手术组有明显的优势。结论腹腔镜阑尾切除术治疗急性穿孔性阑尾炎具有创伤小、恢复快、并发症少和平均住院时间短等优点,是治疗穿孔性阑尾炎较理想的手术方式。

[Objective] To evaluate the feasibility and effect of laparoscopic appendectomy（LA） in acute perforative appendicitis comparing with open appendectomy （OA）. [Methods ] 112 patients with acute perforative appendicitis who underwent appendectomy were retrospectively studied . Among them, 73 cases were treated with laparoscopic appendectomy and 39 cases with open appendectomy. The operation time, recovery period, use of pain-killer ,complications, and the period and the cost for hospitalizing were studied. [ Results ] There were significant differences between LA and OA among these indexes （except the operation time,the incidence of residual abscess and the cost for hospitalizing）（P 〈0.05）. [ Conclusion] Compared with OA, LA is a more popular choice for the patients with acute perforative appendicitis because of its advantages of minimal invasion, early recovery, few complications and short hospitalization time.