腹腔镜与微创小切口阑尾切除术治疗老年急性阑尾炎的临床疗效比较

The clinical efficacy of laparoscopy and minimally invasive incision appendectomy for elderly acute appendicitis

目的探讨腹腔镜手术与微创小切口手术治疗老年急性阑尾炎的临床疗效及安全性,为老年急性阑尾炎患者最佳术式的选择提供依据。方法选取120例老年急性阑尾炎患者为研究对象,根据手术方式的不同分为观察组(64例)和对照组(56例),其中观察组患者应用腹腔镜下阑尾切除术治疗,对照组患者应用小切口阑尾切除术,对两组患者手术时间、术中出血量、术后首次肛门排气时间、术后并发症、住院时间及住院总费用进行比较。结果观察组患者术中出血量、术后首次肛门排气时间、术后并发症及住院时间方面均优于对照组,但住院总费用高于对照组[(8 759.25±275.94)vs(6 372.86±219.67)],两者比较差异均有统计学意义(P<0.05),但两组手术时间比较差异无统计学意义[(48.32±8.57)vs(45.41±7.62)]。结论与小切口阑尾切除术相比,腹腔镜手术治疗老年阑尾炎具有损伤小、术后恢复快、并发症少及住院时间短等优势,具有良好的临床应用前景。

Objective To investigate the clinical efficacy and safety of laparoscopic surgery and minimally invasive incision surgery in the treatment of elderly patients with acute appendicitis,to provide the basis for the choice of the best surgical procedure for the elderly patients with acute appendicitis.Methods120elderly patients with acute appendicitis patients as the research object,according to the different ways of operation were divided into observation group(64cases)and control group(56cases),the observation group were treated with laparoscopic appendectomy,the control group were treated with small incision appendectomy,the two groups of patients with operative time,the amount of bleeding,postoperative anal exhaust time,postoperative complications,hospitalization time and total hospitalization expenses were compared.Results The observation group of intraoperative bleeding,postoperative anal exhaust time,postoperative complications and hospitalization time were better than the control group,but the total cost of hospitalization was higher than the control group[(8759.25±275.94)vs(6372.86±219.67),the difference was statistically significant(P<0.05).But the operation time of the two groups had no statistically significant difference between[(48.32±8.57)vs(45.41±7.62)].Conclusion For the small incision appendectomy,laparoscopic surgery has the advantages of less injury,faster postoperative recovery,less complications and shorter hospital stay,and it has a good clinical application prospect.