开腹与腹腔镜手术治疗小儿穿孔性阑尾炎的对比分析

Contrastive analysis laparoscopic versus open appendectomy in the treatment of perforated appendicitis in children

目的对比分析开腹阑尾切除术(OA)与腹腔镜阑尾切除术(LA)对小儿穿孔性阑尾炎的疗效。方法回顾性分析2012年1月-2014年1月收治的221例穿孔性阑尾炎患儿,其中OA组130例,LA组91例。比较两组的手术情况、并发症及预后。结果在术中出血量、下床活动时间,肠道恢复时间、总并发症率方面,LA优于OA,差异有统计学意义(P<0.05)。OA组手术时间短于LA组,差异有统计学意义(P<0.05)。OA组与LA组的住院天数、腹腔残余感染率比较,差异均无统计学意义(P>0.05)。结论与OA相较,LA治疗穿孔性阑尾炎具有出血少,恢复快,并发症率低等优点,但在缩短手术时间、住院时间和减少腹腔残余感染方面没有显著优势。

Objective To compare the efficacy of open appendectomy（OA） and laparoscopic appendectomy（LA） of the perforated appendicitis in children.Methods A total of 221 children with perforated appendicitis from Jan 2012 to Jan 2014,130 in OA group and 91 in LA group,were retrospectively analyzed.The surgical situation,complications an therapeutic effects were compared between the two groups.Results There were statistical difference between the two groups（P〈0.05）,in the bleeding volume,the time of starting ambulation,the time of intestinal recovery and total incidence of complications,LA was better than OA.OA operation time was shorter than LA,the differences between two group were statistically significant（P〈0.05）.There was no statistical difference in hospitalization time and abdominal residual infection between the OA and LA（P〉0.05）.Conclusion Compared with OA,LA has advantage in less bleeding volume,faster recovery and fewer complication.But LA hasn＇t advantage in shorter operation and hospitalization time,lower abdominal residual infection.