腹腔镜与开腹阑尾切除术996例临床对比分析

The clinical comparison research of Laparoscopic or open appendectomy

目的对比分析腹腔镜阑尾切除(Laparoscopic appendectomy,LA)与开腹阑尾切除(Open laparotomy ap-pendectomy,OA)两种术式在治疗阑尾炎时的疗效、术后恢复情况和术后并发症发生率间存在的差异,尝试做出相应评价。方法对我院2005年6月～2010年6月间按设计随机分组采用LA或OA法实施阑尾切除的996例(LA组485例,OA组511例)患者的疗效、术后恢复情况和并发症发生情况等相关临床资料进行统计学分析。结果两种术式对治疗阑尾炎具有同样的疗效,手术耗时无差异(P>0.05),但LA在提早下床活动、减轻切口疼痛、缩短住院时间、降低术后并发症发生率方面与OA存在显著差异(P<0.05)。结论 LA在治疗阑尾炎时除可取得与OA相同的疗效外,还具有比OA创伤小、术后疼痛轻、恢复快、并发症少等诸多优点,普外科医生应重视LA的临床应用,但对不能耐受人工气腹以及发病时间长且阑尾区发现炎性肿块的患者仍应开腹手术。

Objective To compare LA（Laparoscopic appendectomy,LA） and OA（Open laparotomy appendectomy,OA）two surgical treatment of appendicitis when the efficacy of postoperative recovery and Complications,try to make the appropriate evaluation.Methods 996 cases of appendectomy patients（LA group of 485 cases,OA group of 511 cases） from June 2005 to June 2010 were designed randomized between LA or OA,then analyzed of postoperative recovery and postoperative complications related to the clinical data.Results Two surgical procedures on the treatment of appendicitis had the same effect,no difference in operative time（P0.05）,but LA was significant difference（P0.05） in the early ambulation,reduce postoperative pain,shorter hospital stay,lower complication rate.Conclusion In the treatment of appendicitis LA except get the same effect with OA,to better in micro-trauma,postoperative pain,rapid recovery,fewer complications and many other advantages,general surgeons should be pay attention to the clinical application of LA,but not adjust to patients can not be tolerated pneumoperitoneum and found Inflammatory bump in the appendix.