内镜下逆行阑尾炎治疗术治疗急性非复杂性阑尾炎的疗效分析

Therapeutic Effect of Endoscopic Retrograde Appendicitis on Acute Noncomplex Appendicitis

目的探讨内镜逆行性阑尾炎(ERAT)治疗急性单纯性阑尾炎的有效性和安全性。方法自2014年10月—2015年1月,该院共收集108例诊断为急性单纯性阑尾炎的患者。其中男性55人,女性53人,年龄14～73岁。依照不同的治疗方法,可以分为内镜逆行性阑尾炎(ERAT)组和腹腔镜阑尾切除术(LA)组两个组。两组的治疗情况和并发症。后续情况。结果 ERAT组所有患者均成功完成内镜手术,且均未接受手术治疗。LA组中的一名患者接受了开放式阑尾切除术。ERAT组平均手术时间为(49.7±18.2)min,明显低于LA组(68.9±25.9)min(t=4.15,P<0.05)。ERAT组1例并发穿孔,经保守治疗治愈。ERAT随访至少6个月后,阑尾炎复发率为10.00%,LA随访6个月,阑尾炎复发率为15.00%,差异有统计学意义(χ~2=3.68,P>0.05)。结论 ERAT治疗急性非复杂性阑尾炎是一种安全有效的方法。它具有创伤少,恢复快的优点。特别是急性非并发阑尾炎伴有结石和阑尾狭窄的患者应该被用作ERAT的最佳指征。

Objective To investigate the efficacy and safety of endoscopic retrograde appendicitis （ERAT） in the treatment of acute simple appendicitis. Methods From October 2014 to January 2015, a total of 108 patients diagnosed with acute simple appendicitis were enrolled in the hospital, 55 males and 53 females, aged 14~73 years old. According to different treatment methods, it can be divided into two groups： endoscopic retrograde appendicitis （ERAT） group and laparoscopic appendectomy （LA） group. Treatment condition and complications, follow-up situation in both groups were compared. Results All patients in the ERAT group successfully completed endoscopic surgery and did not receive surgery. One patient in the LA group underwent an open appendectomy. The mean operative time in the ERAT group was （49.7±18.2） min, which was significantly lower than that in the LA group （68.9±25.9）min （t=4.15, P〈0.05）. One patient in the ERAT group had a perforation and was cured by conservative treatment. After ERAT follow-up for at least 6 months, the recurrence rate of ERA7 group was 10.00%. the recurrence rate of LA group was 15.00%（χ2=3.68, P〉0.05）. Conclusion ERAT is a safe and effective method for the treatment of acute non-complex appendicitis. It has the advantages of less trauma and quick recovery. In particular, patients with acute non-concurrent appendicitis with stones and appendix stenosis should be used as the best indication for ERAT.