小儿急性阑尾炎采用腹腔镜手术与开腹手术的临床对比

Clinical Comparison of Laparoscopic and Open Surgery for Acute Appendicitis in Children

目的对比小儿急性阑尾炎采用腹腔镜与开腹手术方式的临床效果。方法应用随机抽样法,选取2012年7月—2019年10月该院收治的急性阑尾炎患儿180例,分为LA组90例,OA组90例。LA组采用腹腔镜手术,OA组采用开腹手术。比较两组患儿的手术时间、术中出血量、术后胃肠功能恢复时间、术后住院时间以及切口感染、腹腔脓肿、肠粘连肠梗阻并发症情况及满意度。结果LA组手术时间(71.65±27.04)min略长于OA组(69.46±28.16)min,差异无统计学意义(t=0.532,P=0.595>0.05);LA组术中出血量(4.96±1.50)mL、术后胃肠功能恢复时间(15.51±4.66)h、术后住院时间(6.98±1.24)d、切口感染(1.1%)、腹腔脓肿(1.1%)、肠粘连肠梗阻(2.2%)并发症发生率均优于OA组,差异有统计学意义(t=24.189、13.619、5.033,χ^2=7.843、4.211、4.744,P<0.05)。结论小儿急性阑尾炎采用腹腔镜手术,创伤小,恢复快,术后并发症少,家长满意度高,可作为首选手术方式。

Objective To compare the clinical effects of laparoscopic and open surgery in children with acute appendicitis.Methods A random sampling method was used to select 180 children with acute appendicitis admitted to the hospital from July 2012 to October 2019.They were divided into 90 cases in the LA group,90 cases in the OA group,laparoscopic surgery in the LA group and open laparoscopic surgery in the OA group,the operation time,intraoperative blood loss,postoperative gastrointestinal function recovery time,postoperative hospital stay and complications of incision infection,abdominal abscess,intestinal adhesions and intestinal obstruction,and satisfaction were compared between the two groups.Results The operation time of LA group(71.65±27.04)min was slightly longer than that of OA group(69.46±28.16)min,after comparison,the difference was not statistically significant(t=0.532,P=0.595>0.05);LA group intraoperative bleeding volume(4.96±1.50)mL,postoperative gastrointestinal function recovery time(15.51±4.66)h,postoperative hospital stay(6.98±1.24)d,incision infection(1.1%),abdominal abscess(1.1%),bowel adhesive intestinal obstruction(2.2%),the complication rate was better than that of the OA group,the difference was statistically significant(t=24.189,13.619,5.033,χ^2=7.843,4.211,4.744,P<0.05).Conclusion Laparoscopic surgery for acute appendicitis in children can be used as the preferred surgical method,which has less trauma,quick recovery,few postoperative complications,and high parental satisfaction.