老年患者腹腔镜下急性阑尾炎切除术术后并发症分析

Analysis of post-operation complications of laparoscopic appendectomy in elderly patients With acute appendicitis

目的探讨老年患者腹腔镜下急性阑尾炎切除术与术后相关并发症之间的关系。方法回顾性分析64例因罹患急性阑尾炎行手术治疗的老年患者的临床资料，以手术方式为分组依据，将入选对象分为腹腔镜手术组（38例）及常规开腹手术组（26例），比较两组术后相关并发症（切口感染、肠粘连、出血、腹腔感染、粪瘘及阑尾残株炎等）发生例数的差异。结果两组患者中，腹腔镜组无切口感染病例，发生近期肠粘连发生2例；常规开腹手术组切口感染4例，均为术前合并糖尿病患者，近期肠粘连7例；两组患者中，均无出血、迟发腹腔感染、粪瘘阑尾残株炎病例。所有患者急腹症均得以缓解，无死亡病例。其中切口感染及肠粘连发生例数的分布差异有统计学意义。结论与常规开腹手术相比，腹腔镜下阑尾炎切除术在降低老年患者急性阑尾炎术后相关并发症方面似乎更具优势，可降低切口感染及近期肠粘连的发生率。

Objective To investigate the relationship between laparoscopic appendectomy and relative complications post-operation for the elderly patients with acute appendicitis. Methods The clinical data of 64 elderly patients with acute appendicitis and underwent laparoscopie appendectomy were retrospectively analyzed. According to the different operation mode,all cases were divided into two groups, including laparoscopic operation group 38 cases and conventional open operation group 26 cases. The distribution of cases with complications incision infection, ankylenteron ,bleeding, abdominal infection, stercoral fistula, appendix stump inflammation post-operation were compared between the two groups. Results Between two groups, incision infection and intestinal cases distribution difference had statistical significance while in the aspects of bleeding, abdominal infection, fistula and appendix stump inflammation,there was no significant difference. Conclusion Compared with conventional open operation ,for elderly patients with acute appendicitis, laparoscopic appendectomy appeared to have an advantage to reduce postoperative complications, which could reduce the incision infection and the incidence of intestinal adhesion.