腹腔镜与开腹手术对阑尾炎女性患者的疗效比较

Comparison on the Effects of Laparoscopic and Opening Appendectomy for Female Patients of Appendicitis

目的:对比分析腹腔镜阑尾切除术及开腹阑尾切除术在年轻女性中的探查效果及手术效果。方法:回顾性分析本院普通外科2005年1月-2008年12月行阑尾切除术的女性患者共374例的临床资料,其中腹腔镜阑尾切除术(LA)215例,开腹阑尾切除术(OA)共159例,比较两组病例手术时间、住院天数、术后并发症。结果:LA组的手术时间(56.51±8.42)min,OA组(65.05±6.60)min;LA组的住院时间(2.62±0.76)d,而OA组(5.3±0.49)d,两组比较差异有统计学意义(P<0.01)。LA组术后无伤口感染或脂肪液化,有1例腹腔脓肿发生,而OA组则分别为16例和4例;LA组无发生术后肠梗阻,OA组有48例病例发生术后肠梗阻,两组术后并发症的比较差异有统计学意义(P<0.01)。结论:腹腔镜阑尾切除术治疗阑尾炎女性患者与开腹阑尾切除术相比具有创伤少、恢复快、并发症少和住院时间少等的优点,同时腹腔镜手术能够同时探查腹腔其他脏器,发现除阑尾炎外的其他疾病,是治疗阑尾炎女性患者的较理想的手术方式。

Objective：To compare and analyze the effects of laparoscopic appendectomy（LA）and opening appendectomy（OA）for female patients with appendicitis. Method：To make a retrospective analysis on the clinical data of 374 female patients with appendicitis from Jan 2005 to Dec 2008 of general surgery in the hospital,in which 215 patients were treated by LA and 159 by OA. To compare the differences of operation time,hospital stays,and postoperative complication of the two groups. Result：The operation time of LA was（56.51±8.42）minutes,and（65.05±6.60）minutes of OA. The hospital stays of LA were（2.62±0.76）days,and（5.3±0.49）days of OA,with statistical significance（ P 0.01）. There was no wound infection or fat liquefaction in LA group,and 1 case abdominal abscesses. However,in OA group the numbers were 16 and 4 separately. There were 48 cases suffered ileus in OA group but none case in LA group. The contrast of postoperative complications also had statistical significance（ P 0.01）. Conclusion： Compared with OA,LA has advantages such as less wounding,faster recovery,less complications and shorter hospital stays. At the same time,LA can also explore other viscera and detect other diseases except appendicitis. So LA is a more ideal operation manner for female patients of appendicitis.