腹腔引流管在腹腔镜慢性阑尾炎手术中的应用价值?

The application value of abdominal drainage tube in the laparoscopic appendectomy for chronic appendicitis

目的:探讨腹腔引流管在慢性阑尾炎腹腔镜手术中的应用价值。方法:回顾分析2006年1月至2014年12月为136例慢性阑尾炎患者施行腹腔镜阑尾切除术的临床资料,根据术后是否放置腹腔引流管分为放置组(n=70)与未放置组(n=66),对比两组手术时间、住院时间、初次排气时间、止痛药的需求次数、术后并发症;随访患者术后慢性腹痛的改善情况。结果:两组手术时间、住院时间、初次排气时间、止痛药的需求次数差异无统计学意义(P>0.05),术后两组患者腹腔脓肿发生率差异有统计学意义(0 vs.5,P=0.025),肠梗阻(2 vs.4,P=0.431)、切口感染(2 vs.3,P=0.674)、慢性腹痛(5 vs.7,P=0.554)差异无统计学意义。结论:慢性阑尾炎腹腔镜阑尾切除术后放置腹腔引流管对患者术后恢复无明显影响,但对于术后监测腹腔脓肿的形成及治疗具有重要临床意义。

Objective：To investigate the value of intra-abdominal drainage tube in the laparoscopic appendectomy for chronic appendicitis. Methods：In this study, the clinical data of 136 patients, who suffered from chronic appendicitis and underwent laparoscopic appendectomy from Jan. 2006 to Dec. 2014, were retrospectively collected. After the operation,70 cases were randomly chosen to place the intra-abdominal drainage tube in the pelvic cavity, while the other 66 patients not. The operation time, hospital stay, first exhaust time, times of analgesic demanding and the postoperative complications were compared between the two groups. And the improvement of postoperative chronic abdominal pain was also followed up. Results： There were no statistically significant differences between the two groups in operative time, hospital stay, first exhaust time and times of analgesic demanding （ P 〉 0.05 ）. However, there was significant difference in the postoperative abdominal abscess （0 vs. 5, P = 0.025 ） between the two groups, while the other complications such as intestinal obstructions （2 vs. 4, P = 0.431 ）, infection of incision （ 2 vs. 3, P = 0. 674）, chronic abdominal pain （5 vs. 7, P = 0. 554） were not statistically significantly different. Conclusions ： The placement of intra-abdominal drainage tube after the laparoscopic appendectomy for the chronic appendicitis does not affect the postoperative recovery, while the character and volume of the drainage fluids could be a hint for the diagnosis of postoperative intra-abdominal abscess. And the irrigation of the drainage tube could be a good therapy for the intra-abdominal abscess.