腹腔镜对不同类型阑尾炎的手术疗效分析

Analysis on the Curative Effect of Laparoscopic Surgery for Different Types of Appendicitis

目的:分析腹腔镜对不同类型阑尾炎的手术疗效。方法:选取2011年2月～2012年1月在我院普外科接收手术治疗的阑尾炎患者215例进行回顾性分析,所有患者均行阑尾切除手术,比较不同类型的阑尾炎患者接受腹腔镜手术和开腹手术治疗后的临床疗效。结果:单纯急慢性阑尾炎、化脓性阑尾炎未穿孔及化脓性阑尾炎穿孔患者中行腹腔镜手术者住院时间分别为(5.2±1.1)天、(5.6±1.2)天、(6.1±1.3)天;术后12小时应用止痛药的患者比例分别为1.8%、2.7%、0.0%,均明显低于经腹手术患者。但是在比较化脓性阑尾炎伴穿孔患者术后残余脓肿的患者比例时,腹腔镜下手术的患者术后残余脓肿的患者比例为20.7%,明显高于对照组。以上P均小于0.05。结论:对于单纯急慢性阑尾炎、化脓性阑尾炎未穿孔患者,腹腔镜下阑尾切除术能够显著地降低住院时间及术后止痛药物使用的比例,临床疗效良好。但是对于急性化脓性阑尾炎穿孔患者,腹腔镜手术能够增加术后脓肿残余的比例,在临床上是否广泛应用值得进一步探讨。

Objective：To analyze the curative effect of laparoscopic surgery for different types of appendicitis.Methods：From February,2011 to January 2012,make a retrospective analysis on 215 patients with appendicitis in our general surgery.All the patients were given appendectomy.Compare the curative effect of laparoscopic surgery and open surgery for the patients with different appendicitis.Results：In laparoscopic surgery,the hospitalizations of simple acute and chronic appendicitis,suppurative appendicitis without perforation and suppurative appendicitis with perforation are（5.2±1.1）days,（5.6±1.2）days and（6.1±1.3）days;and the rates of using painkillers in 12 hours are 1.8%,2.7% and 0.0% after surgery.They were significantly lower than the open surgery.But the rate of patients with postoperative residual abscess is 20.7% for suppurative appendicitis with perforation.It is significantly higher than the control group（P0.05）.There was a significant difference in statistics.Conclusion：For the patients with simple acute and chronic appendicitis,suppurative appendicitis without perforation,the laparoscopic surgery can decrease the time of hospitalization and the rates of using painkillers significantly.It has a better curative effect.But for the patients with suppurative appendicitis with perforation,the laparoscopic surgery will increase the rate of postoperative residual abscess,so whether it can be used in clinic,it is worth to do further exploration.