腹腔镜与开腹阑尾切除术对比分析

Laparoscopic vs conventional appendectomy for appendicitis

目的:对比分析腹腔镜和开腹手术治疗急性阑尾炎的手术效果和优缺点。方法:将150例急性阑尾炎患者分为腹腔镜组(75例)和开放组(75例),比较两组手术的临床指标及术后随访情况。结果:两组手术均顺利完成。腹腔镜组和开放组手术时间分别为31.1±2.1 min和31.1±1.8 min(t=0.00,P>0.05);术中出血量分别为16.2±2.8 mL和28.3±5.3 mL(t=64.62,P<0.05);术后下床活动时间分别为25.1±3.1 h及50.5±2.1 h(t=69.02,P<0.05);术后排气时间分别为29.6±1.6 h和52.1±4.6 h(t=10.92,P<0.05);住院时间分别为3.1±0.8 d及7.9±1.3 d(t=73.42,P<0.05);综合费用分别为6393±42元和4861±33元(t=-12.19,P<0.05);切口感染率分别为0和2%(χ2=25.40,P<0.05);止痛药使用频率分别为4%和32%(χ2=31.63,P<0.05)。随访时间为1～6月(平均3.1)月,切口疝的发生率均为0。结论:腹腔镜治疗急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,是治疗急性阑尾炎较为理想的手术方式。

Objective： To compare laparoscopic appendectomy to conventional operation for the treatment of appendicitis, Methods： In this study 150 patients diagnosed as appendicitis were divided into group A（laparoscopic appendectomy） and group B（conventional operation） according to the random numbers. In group A, 75 patients were treated with laparoscopic appendectomy. In group B, 75 patients were treated with conventional open appendectomy. The inhospital data and that of followed-up were compared. Statistical analysis was carried out using SPSS16.0 for Win- dows. Comparisons between categorical variables and continuous variables were analyzed using the ~ 2 test and t test. Results： The operation was successfully performed in all 300 patients. The operating time in group A and B were （31.1 ± 2.1）min versus （31.1± 1.8） min （t=0.00, P〉0.05）, the blood loss were （16.2 ±2.8）mL versus （28.3± 5.3）mL （t=64.62, P〈0.05）,the bed off activity time were（25.1± 3.1）h versus （50.5 ± 2.1）h （t=69.02, P〈0.05）,the bowels＇ move time were（29.6 ±1.6）h versus （52.1 ±4.6）h （t=10.92, P〈0.05）, the hospital stay were（3.1 ± 0.8）d versus （7.9 ± 1.3）d（t=73. 42, P〈0.05） ,the inhospital cost was （6393 ± 42） yuan versus （4861 ± 33） yuan （t=-12.19, P〈0.05）, the incision infection was 0 and 3 （χ2=25.40, P〈0.05）. Postoperative analgesics were needed in 4% versus 32% （χ2=31.63,P〈0.05）. All the patients were followed-up from 1 months to 6 months （average 3.1 months）. The development of incision hernia in group A and B was 0 （P〉0.05）. Conclusion; Laparoscopic appendectomy is a therapy of choice for patients with acute appendicitis with advantages of minimal invasion, early recovery, few complications and short hospital stay.