腹腔镜在急性化脓性阑尾炎手术中的应用

Application of laparoscope in the surgical treatment of acute suppurative appendicitis

目的探讨腹腔镜在急性化脓性阑尾炎治疗中的临床效果。方法选取我院2012年1月至2016年12月收治的急性化脓性阑尾炎患者122例,根据术式不同分为腹腔镜组(57例)和常规开腹组(65例),比较两组患者手术时间、术中出血量、手术切口长度、术后首次下床活动时间、术后肛门排气时间、术后镇痛药使用情况、术后并发症发生情况、住院天数及住院费用等指标。结果与常规开腹组比较,腹腔镜组术中出血量少、术后镇痛药使用率低,切口长度、术后首次下床活动时间、肛门排气时间及住院时间短,但住院费用多,差异有统计学意义(P<0.05);腹腔镜组术后并发症发生率为1.8%,低于常规开腹组的13.9%,差异有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05)。结论腹腔镜阑尾切除术治疗急性化脓性阑尾炎疗效确切,可减轻患者痛苦、促进术后恢复、缩短住院时间、降低术后并发症的发生。

Objective To explore the clinical effect of laparoscopic appendectomy（LA） in the surgical treatment of acute suppurative appendicitis. Methods A total of 122 cases of patients with acute suppurative appendicitis treated in our hospital from January 2012 to December 2016 were selected and divided into LA group（n=57） and open appendectomy（OA） group（n =65） according to different surgical ways. The operation time, peri-operative bleeding, operative incision lengths, postoperative activity time, postoperative exhausting time, analgesic use situation, complications, hospital days and expenditure between the two groups were compared. Results The LA group resulted in a lower blood loss and analgesic use rate, shorter operative incision lengths, postoperative activity time, postoperative exhausting time and hospital days than the OA group, but the expenditure in LA group was more than OA group（P〈0.05）. The complication rate in LA group（1.8%）was lower than OA group（13.9%）（P〈0.05）. There was no significant difference in operation time between the two groups（P〉0.05）. Conclusion In the treatment of acute suppurative appendicitis, laparoscopic appendectomy can alleviate patient＇s pain, promote postoperative recovery, shorten hospitalization time and reduce the postoperative complications.