儿童急性化脓性阑尾炎穿孔继发腹盆腔多发脓肿的腹腔镜下探查治疗术应用分析

Application Analysis of Laparoscopic Exploration and Treatment of Multiple Abdominal and Pelvic Abscesses Secondary to Perforation of Acute Suppurative Appendicitis in Children

目的分析儿童及幼儿急性阑尾炎穿孔继发腹盆腔多发脓肿的腹腔镜下探查治疗术应用现状。方法该次研究方便选取2014年6月—2019年6月该院收治的儿童及幼儿急性阑尾炎穿孔并阑尾周围脓肿、腹盆腔多发脓肿形成的患儿共计72例,按照接诊顺序奇偶性分为观察组及对照组,各36例,观察组采用腹腔镜下探查、腹盆腔多发脓肿切除并置管引流术+腹腔镜下阑尾切除术;对照组采用保守抗感染+开腹探查脓肿切除、阑尾切除术治疗,分析两组患者的各项指标,利用统计学方法研究两者的差异。结果对照组总有效率75%,观察组总有效率97%,差异有统计学意义(χ^(2)=7.432,P<0.05);相较于对照组,观察组的切口长度、手术时间和住院费用均较优,差异有统计学意义(P<0.05);相较于对照组并发症9例(25%),观察组并发症为2例(6%),差异有统计学意义(χ^(2)=5.282,P<0.05)。结论总体来看,腹腔镜下探查治疗急性阑尾炎并腹盆腔脓肿,诊断明确、腹腔内探查范围广,不仅腹壁伤口微小美观,而且手术精准、创伤小、术后恢复快、效果确切,并发症少,具有临床优势。

Objective To analyze the current status of laparoscopic exploratory treatment of multiple abdominal and pelvic abscesses secondary to acute appendicitis perforation in children and infants.Methods In this study,a total of 72 patients with acute appendicitis perforation in children and young children admitted to the hospital from June 2014 to June 2019 with peri-appendic abscess and multiple abdominal and pelvic abscess were conveniently selected.They were divided into observation group and the control group according to the odds of the admission order,each with 36 cases.The observation group used laparoscopic exploration,resection of multiple abdominal and pelvic abscesses with catheter drainage+laparoscopic appendectomy;while the treatment control group used conservative anti-infection+open abdominal exploratory abscess resection,appendix resection treatment,analyzing the indicators of the two groups of patients,and using statistical methods to study the differences between the two groups.Results The total effective rate of the control group was 75%,the total effective rate of the observation group was 97%,the difference between the two groups was statistically significant(χ^(2)=7.432,P<0.05);compared with the control group,the length of incision,operation time and hospitalization cost was relatively good in the observation group,and the difference was statistically significant(P<0.05);compared with 9 cases(25%)in the control group,there were 2 cases(6%)in the observation group,the difference was statistically significant(χ^(2)=5.282,P<0.05).Conclusion In general,laparoscopic exploration and treatment of acute appendicitis and abdominal and pelvic abscess has a clear diagnosis and a wide range of intra-abdominal exploration.Not only the abdominal wall wound is small and beautiful,but also the operation is precise,the trauma is small,the postoperative recovery is quick,the effect is accurate,and the complications are few,which has clinical advantages.