妊娠期应用腹腔镜治疗阑尾炎的临床体会

Clinical experience of laparoscopic treatment of appendicitis during pregnancy

目的：探讨妊娠期合并阑尾炎应用腹腔镜治疗的临床可行性。方法：对比分析2010年3月至2014年6月为113例妊娠期合并阑尾炎患者分别行腹腔镜阑尾切除术（n=28）及传统阑尾切除术（n=85）的手术疗效。结果：腹腔镜手术组23例顺利切除阑尾,5例中转开腹,手术时间30~60 min,术后住院2~4 d,切口感染1例（中转开腹）,诱发早产1例（中转开腹）,随访至产后母子均平安。传统手术组均顺利切除阑尾,手术时间30~90 min,术后住院7~19 d,切口感染7例,盆腔积液3例,诱发早产1例,流产2例。结论：妊娠期合并阑尾炎应用腹腔镜治疗明显优于传统开腹手术,手术成功率高,疗效好,并发症少,值得临床推广应用。

Objective：To investigate the clinical feasibility of laparoscopic treatment for the patients with appendicitis in pregnancy. Methods：The clinical data of patients with appendicitis in pregnancy performed laparoscopic appendectomy （28 cases） and traditional appendectomy surgery （85 cases） from Mar. 2010 to Jun. 2014 in Baoding First Central Hospital were retrospectively analyzed. Results：Laparoscopic surgery group：23 cases accepted successful appendectomy,5 cases were converted to laparotomy, surgery time was 30-60 rain, postoperative hospital time was 2-4 d. Two patients suffered from postoperative complications,including wound infection in 1 patient （laparotomy） and induced preterm birth in 1 patient （laparotomy）, both mother and child were in safe condition according to follow-up investigation. Conventional surgery group：all patients accepted successful surgery and the appendix was removed, operative time was 30-90 min,postoperative hospital time was 7-19 d,thirteen patients suffered from postoperative complications,including wound infection in 7 patients,pelvic effusion in 3 patients, induced preterm birth in 1 patient, miscarriage in 2 patients. Conclusions：Laparo- scopic treatment of pregnant women with appendicitis is significantly better than traditional surgery ,with high surgical success rate ,high surgery quality ,few complications, is worthy of clinical application.