对比探究腹腔镜与开腹手术用于小儿急性阑尾炎治疗中的临床差异

Contrast to explore the laparoscopic and open operation for the treatment of children acute oppendicitis differenes

目的对比分析不同手术方案在小儿急性阑尾炎临床治疗中的应用情况。方法选取笔者所在医院小儿外科106例小儿急性阑尾炎患者纳入本组研究,患儿资料选择起止时间为2016年6月至2018年6月。采用随机数表法将纳入研究的患者随机分为2组,每组53例,分别实施开腹手术治疗与腹腔镜手术治疗,并设为对照组和研究组。观察统计两组的手术相关临床情况、手术后相关情况,并记录两组手术相关并发症发生情况。结果观察比较两组手术相关情况,可得研究组的平均手术时长与术中出血量较对照组均明显偏短或偏少(P<0.05);手术后情况组间比较显示存在明显差异,研究组平均术后下床活动时间、术后开始排便时间、术后首次肛门排气时间、术后进食时间、术后住院时间较对照组均明显偏短(P<0.05);对照组术后发生肠梗阻、腹腔脓肿、切口感染的患者各有2例,另有3例患者出现恶心呕吐现象,并发症总发生率为16.98%,明显高于研究组的5.66%(P<0.05)。结论与开腹手术相比,对小儿急性阑尾炎患者实施腹腔镜手术治疗效果显著,具有手术时间短、术中出血少等特点,且术后并发症发生率低,患儿术后恢复更快。

Objective to compare and analyze the application of different surgical plans in the clinical treatment of acute appendicitis in children.Methods 105 cases of pediatric acute appendicitis patients were included in the study.The data selection time of patients was from June 2016 to June 2018.The patients enrolled in the study were randomly divided into two groups,53 in each group,and were treated with open abdominal surgery and laparoscopic surgery,and were set up as control groups and research groups.To observe the operation related clinical situation and post-operation related situation of the two groups,and to record the two groups of surgical related complications.Results To observe and compare the two groups of operation related conditions,the average duration of operation and the amount of bleeding in the study group were significantly shorter or less than those in the control group(P<0.05).There were significant differences in the post-operative group.The average post-operative time for getting out of bed,starting bowel movement,first postoperative anal exhaust time,post-operative feeding time,and post-operative hospitalization time were all significantly shorter than those of the control group.(P<0.05);There were 2 cases of intestinal obstruction,abdominal abscess,and incision infection in the control group,and 3 cases of nausea and vomiting.The total incidence of complications was 16.98%,which was significantly higher than the 5.66%of the study group(P<0.05).Conclusion compared with open abdominal surgery,laparoscopic surgery was effective in children with acute appendicitis.It had the characteristics of short operation time,little bleeding in surgery,and low incidence of postoperative complications,and children recovered faster after surgery.