腹腔镜阑尾切除术的阑尾根部及系膜的两种处理方法的对比

Comparison of two Methods of Treatment of Appendiceal Root and Mesentery in Laparoscopic Appendectomy

目的:研究腹腔镜阑尾切除术阑尾根部及系膜的两种处理方法的对比。方法:选取2017年7月至2019年5月我院收治的因阑尾炎行阑尾切除患者60例作为研究对象,进行回顾性分析,根据患者处理方式的不同将其分为观察组31例、对照组29例,观察组采用hem-o-lok夹闭法进行根部及系膜切除,对照组采用丝线结扎法进行根部及系膜切除。观察两组患者手术时间、手术中出血量、术后下床时间、排气时间、住院时间、住院费用等情况,并对两组患者术后并发症情况进行观察记录。结果:观察组患者手术时间、手术中出血量显著少于对照组;住院费用显著高于对照组,差异具有显著性(P<0.05);术后下床时间、排气时间、住院时间相较,差异无显著性(P>0.05);观察组患者术后并发症中腹胀发现率显著少于对照组,差异具有显著性(P<0.05);腹泻、呕吐、疼痛、肠梗阻、感染发生率与总发生率相较,差异无统计学意义(P>0.05)。结论:腹腔镜阑尾切除术中hem-o-lok夹闭法与丝线结扎法对阑尾根部及系膜两种处理方法均安全可靠,但hem-o-lok夹闭法手术时间更短、术中出血量少,但是丝线结扎法切除患者其住院费用较低,更加经济实惠。

Objectives:To study the comparison of two treatments of appendix root and mesentery in laparoscopic appendectomy. Methods: From July 2017 to May 2019, 60 patients with appendicitis who underwent appendectomy in our hospital were selected as the research objects for retrospective analysis. According to the different treatment methods of patients, they were divided into observation group(31 cases) and control group(29 cases). The observation group was treated with heme-o-lok clamp to remove the root and mesentery. The control group was treated with thread ligation to remove the root and mesentery. The operation time, the amount of bleeding during operation, the time of getting out of bed, the time of exhaust and the cost of hospitalization were observed, and the postoperative complications of the two groups were observed and recorded. Results: The amount of bleeding in the observation group was significantly lower than that in the control group, and the hospitalization cost was significantly higher than that in the control group(P<0.05). There was no significant difference in the time of getting out of bed, exhaust time and hospitalization time after operation(P> 0.05), but the detection rate of abdominal distension in the observation group was significantly lower than that in the control group(P<0.05). There was no significant difference in the incidence of diarrhea, vomiting, pain, intestinal obstruction and infection between the two groups(P> 0.05). Conclusion: The method of the hem-o-lok clamp closure and the ligation of the silk thread under the laparoscope is safe and reliable, but the operation time of the hem-o-lok clamp is shorter and the amount of blood loss during the operation is less, but the hospitalization expense of the patients with the ligation of the silk is lower and the cost is more economical.