腹腔镜与开腹手术治疗阑尾周围脓肿的对比分析

A Comparative Analysis of the Curative Effect of Laparoscopy and Conventional Laparotomy in the Treatment of Periappendiceal Abscess

目的 探讨腹腔镜手术治疗阑尾周围脓肿的疗效与优势.方法 回顾分析我院2010年3月～2013年3月120例阑尾周围脓肿手术患者的临床资料,2011年3月前以开腹手术为主,以后均为腹腔镜手术,各60例,比较2组手术时间、胃肠功能恢复时间、抗生素应用时间、住院时间等指标.结果 2组手术均获成功,腹腔镜组无中转开腹.腹腔镜组手术时间短[（58.2±3.4）minvs.（78.5±2.5）min,t=-36.911,P=0.000],排气早[（23.8±3.8）h vs.（46.4±4.0）h,t=-31.526,P=0.000],术后抗生素应用时间短[（5.5±1.2）d vs.（8.2±1.5）d,t=-10.887,P=0.000],住院时间短[（6.1±1.2）d vs.（9.2±1.6）d,t=-12.006,P=0.000],术后并发症少[3例vs.12例,Х^2=6.171,P=0.013].结论 对于腹腔镜手术操作熟练且有经验的医师,阑尾周围脓肿行腹腔镜手术治疗具有独特优势.

Objective To explore the curative effect and advantage of therapeutic laparoscopy of periappendiceal abscess.Methods We retrospectively analyzed the data of 120 patients undergoing periappendiceal abscess surgery in our hospital from March 2010 to March 2013.Open laparotomy was given priority before March 2011,and laparoscopic surgery was performed for all cases after that.There were 60 cases in each group.Operation time,gastrointestinal function recovery time,antibiotic application time,and the length of hospital stay were compared between the two groups.Results The surgeries in both two groups were successful,with no conversion to open surgery in laparoscopic group.Compared with the open group,laparoscopy group had significantly shorter operation time [（58.2 ± 3.4） min vs.（78.5-± 2.5） min,t =-36.911,P =0.000],quicker recovery of gastrointestinal function [（23.8 ± 3.8） h vs.（46.4±4.0） h,t =-31.526,P=0.000],shorter postoperative antibiotics application time [（5.5 ±1.2） d vs.（8.2±1.5） d,t=-10.887,P=0.000],shorter hospital stay [（6.1 ±1.2） d vs.（9.2±1.6） d,t=-12.006,P=0.000] and fewer complications [3 cases vs.12 cases,Х^2 =6.171,P =0.013].Conclusion Laparoscopic surgery for the treatment of periappendiceal abscess has a unique advantage for skilled laparoscopic surgeon and experienced doctor.