腹腔镜手术与开腹手术治疗小儿急性化脓性阑尾炎的疗效比较

The comparison of curative effect between laparoscopic and open surgery in treatment of acute suppurative appendicitis in children

目的:比较小儿急性化脓性阑尾炎行腹腔镜阑尾切除术(laparoscopic appendectomy,LA)与开腹阑尾切除术(open appendectomy,OA)的疗效。方法:回顾分析手术治疗的102例急性化脓性阑尾炎患儿的临床资料,其中57例行LA,45例行OA,对比两组手术时间、住院时间、肠道排气时间、引流管留置时间、引流管引流量、术后切口感染、术后腹腔脓肿形成及肠粘连等情况。结果:OA组手术时间短于LA组,差异有统计学意义(P<0.05);LA组术后住院时间、肠道排气时间、引流管留置时间、引流管引流量、术后切口感染、腹腔脓肿发生率优于OA组,差异有统计学意义(P<0.05);术后肠粘连发生率两组差异无统计学意义(P>0.05)。结论:小儿急性化脓性阑尾炎行LA具有创伤小、康复快、并发症发生率低等优点,在适应证明确的患儿中值得推广应用。

Objective：To evaluate the outcome of laparoscopic appendectomy （LA） versus open appendectomy （OA） in chil-dren with acute suppurative appendicitis. Methods ： Clinical data of one hundred and two children who suffered from acute suppurative appendicitis and underwent surgical treatment were retrospectively analyzed. Among them ,57 cases were treated with LA ,while 45 cases were treated with OA. The operation time, hospital stay, the time required for intestinal exhaust,indwelling time of drainage tube, drain-age volume, postoperative incision infection, postoperative intra-abdominal abscess and intestinal adhesion were compared between the two groups. Results ： Operation time of OA group was significantly shorter than that of LA group （ P 〈 0.05 ）. LA group had better post-operative hospitalization time, intestinal exhaust time, drainage tube indwelling time, drainage volume, rate of postoperative incision in-fection and intra-abdominal abscess than OA group （ P 〈 0.05 ）. The difference of postoperative intestinal adhesion incidence was not statistically significant between the two groups （ P 〉 0.05 ）. Conclusions ： LA for children with acute suppurative appendicitis has the advantages of mini-invasion, rapid recovery and few complication incidence. It is worthy of promotion in children with clear indications.