腹腔镜与开腹手术治疗急性阑尾炎的临床对比分析

Comparative analysis between laparoscopy and laparotomy in the treatment of acute appendicitis

目的:对比分析腹腔镜与开腹手术治疗急性阑尾炎的临床疗效。方法:选取2012年2月至2013年2月150例急性阑尾炎患者作为研究对象。其中60例行腹腔镜手术(腹腔镜组),90例行开腹手术(开腹组),对比两组患者手术时间、出血量、术后胃肠功能恢复时间、下床活动时间、切口大小、感染情况、治疗总费用及手术前后患者白细胞、中性粒细胞、淋巴细胞水平的变化。结果:与开腹组相比,腹腔镜组手术时间、术后胃肠功能恢复时间、恢复下床活动时间均明显缩短,且出血量较少,切口小,差异有统计学意义(P<0.05)。术后第1天,开腹组白细胞、中性粒细胞水平升高,且明显高于腹腔镜组;术后第3天,各项指标逐渐降低并趋于正常水平,但开腹组白细胞水平仍高于腹腔镜组(P<0.05)。结论:腹腔镜手术治疗急性阑尾炎具有切口小、患者恢复时间短、痛苦少、住院时间短、全身反应较小等优势,但其治疗费用相对较高。

Objective：To comparatively analyze the clinical effect of laparoscopy and laparotomy in the treatment of acute ap- pendicitis. Methods：There were 150 patients of acute appendicitis who were chosen as the research objects and underwent laparoscopy or laparotomy from Feb. 2012 to Feb. 2013. Sixty patients were treated with laparoscopic surgery （the laparoscopy group） and ninety pa- tients were treated with open appendectomy （ the laparotomy group）. The differences between the two groups in terms of operation time, blood loss ,the recovery time of postoperative gastrointestinal function ,time of ambulation after surgery, incision size, infection, the total treatment cost, the preoperative and postoperative level of patients＇ WBC, neutrophil granulocyte and lymphocyte were comparatively an- alyzed. Results： Comparing with the laparotomy group, the laparoseopy group was obviously shorter in the operation time, the recovery time of gastrointestinal function and the time to ambulation after surgery. Furthermore, volume of blood loss decreased significantly and the incision size was also smaller in laparoseopic group. The differences were statistically significant （ P 〈 O. 05 ）. On the first day after operation ,the level of WBC and neutrophil granulocyte of the laparotomy group rose ,which was obviously higher than that of the laparo- scopie group. Every index gradually returned to the normal on the third day after surgery, but the level of WBC in laparotomy group was still higher than that of the laparoseopy group （P 〈 0.05）. Conclusions：Compared with laparotomy,laparoscopy has advantages in the treatment of acute appendicitis, which mainly embody in the following aspects ： smaller wound, shorter recovery time and hospital stay, less pain and systemic reaction but the treatment cost is relatively higher. So it is the most ideal operation choice for the patients who are economic prosperity and eager for less pain and shorter recovery time.