两种方式处理阑尾根部在腹腔镜阑尾切除术中的应用对照

A contrastive study on two methods dealing with appendix root in laparoscopic appendectomy

目的研究分析7号丝线三重套扎法和可吸收夹固定法处理阑尾根部在腹腔镜阑尾切除术中的可靠性和安全性。方法 128例患者行腹腔镜阑尾切除术后随机分为7号丝线三重套扎法组(A组)和可吸收夹固定法处理阑尾根部组(B组),每组64例,比较2组术后并发症及营养状况,以及手术及费用情况。结果 128例患者手术均完全成功,无1例出现并发症,2组患者术后1 d血清前白蛋白、转铁蛋白水平均出现下降,但A组患者血清前白蛋白、转铁蛋白含量在术后3 d的升幅显著高于B组(P<0.01),A组患者手术时间及下床时间显著长于B组,但住院时间和医疗费用显著小于B组(P<0.01)。结论 2种方法处理阑尾根部都是安全可靠的,但腹腔镜7号丝线三重套扎法处理阑尾根部术后营养恢复更快,住院时间更短,且简单易学,容易在医院普及。

Objective To study the reliability and safety of triple loop ligature of 7-0 silk suture and absorbable clips in laparoscopic appendectomy.Methods A total of 128 patients who undertaken laparoscopic appendectomy were divided into group A（n=64） and group B（n=64）.Group A received triple loop ligature of 7-0 silk suture to deal with appendix end,while group B received absorbable clips to deal with appendix end.The complications,nutrient condition,operation condition and costs were detected.Results The surgical operations of 128 patients were all successful with no complications.The levels of serum prealbumin,transferrin in both two groups decreased one day after operation.But the contents of serum prealbumin and transferrin in group A were higher than those in group B three days after operation（P〈0.01）.The operation duration and being able to get out of bed in group A were longer than those in group B,while the length of hospital stay and costs were lower than those in group B（P〈0.01）.Conclusion Both methods are safe and reliable in dealing with appendix end,while the recovery of nutrition is faster and the hospital stay is shorter when triple loop ligature of 7-0 silk suture is applied to deal with appendix root.It is easy to be popularized with its easy operation.