右侧经腹直肌探查切口在小儿阑尾炎切除术中的应用效果分析

Clinical Effects Study of Children Appendix Resection through Right Side Rectus Muscle Abdominal Incision

目的探讨右侧经腹直肌探查切口在小儿阑尾炎切除术中的临床效果。方法选取2012年1月至2014年1月唐山市丰南区妇幼医院行开腹阑尾切除术治疗急性阑尾炎患儿87例,依据随机数字表法分为对照组(经肋缘下切口手术)42例和观察组(经腹直肌探查切口手术)45例,比较两种术式的切口长度、手术时间、术中出血量、术后肛门排气时间、下床时间、止痛药使用情况、抗生素使用时间和并发症发生率。结果对照组切口长度为(6.4±1.7)cm,观察组切口长度为(7.3±2.9)cm,两组比较差异无统计学意义(t=1.58,P>0.05),两组手术时间分别为(56.1±25.8)min和(41.9±13.7)min,差异有统计学意义(t=3.17,P<0.01),术中出血量分别为(16.7±7.3)m L和(13.2±7.1)m L,差异有统计学意义(t=2.27,P<0.05),术后排气时间分别为(2.9±1.1)d和(2.3±0.8)d,差异有统计学意义(t=2.89,P<0.05),术后下床时间分别为(2.6±0.7)d和(2.2±0.8)d,差异有统计学意义(t=2.63,P<0.05),切口感染发生率为9.5%(4/42)和0%,差异有统计学意义(χ2=4.49,P<0.05)。结论在阑尾炎切除术中右侧经腹直肌探查切口与经肋缘下切口具有手术时间短、术中出血量低、术后感染率低等优势,是治疗急性阑尾炎的有效方法。

Objective To study the clinical effects of children appendix resection through right side rec-tus muscle abdominal incision.Methods A total of 87 acute appendicitis children in Tangshan City Feng-nan District Women and Children Hospital treated with open appendectomy from Jan .2012 to Jan.2014 were included in the study,and were divided into control group and observation group：42 patients in the control group were treated with appendix resection through rib incision and 45 patients in the observation group were treated with appendix resection through right side muscle rectus abdominal incision .The length of incision , time of operation, perioperative bleeding volume, postoperative exhaust time, postoperative exercise time, postoperative pain killer usage,antibiotics usage time and complication incidence were compared between the two groups.Results The length of incision in the control group and the observation group was （ 6.4 ± 1.7） cm and （7.3 ±2.9） cm,with no statistic difference（t =1.58,P〈0.05）.The time of operation was （56.1 ±25.8） min and （41.9 ±13.7） min,with statistic difference（t=3.17,P〈0.01）.The perioperative bleeding volume was （16.7 ±7.3） mL and （13.2 ±7.1） mL,with statistic difference（t =2.27,P〈0.05）.The exhaust time was （2.9 ±1.1） d and （2.3 ±0.8） d,with statistic difference（t =2.89,P〈0.05）.The postoperative exercise time was （2.6 ±1.2） d and （2.2 ±0.8） d,with statistic difference（t=2.63,P〈0.01）.The wound infection rate was 9.5% and 0,with statistic difference（χ2 =4.49,P〈0.05）.Conclusion Children appendix resection through right side muscle rectus abdominal incision taked less time in operation,has less perioperative bleeding and lower wound infection rate ,which makes it a better surgery procedure for appendix resection.