小儿急性化脓性阑尾炎伴穿孔的治疗——腹腔镜阑尾切除术与开腹阑尾切除术临床疗效比较

Clinical Efficacy Analysis of Laparoscopic Appendectomy for Acute Suppurative Appendicitis Complicated by Perforation in Children

比较腹腔镜阑尾切除术(1aparoscopie appendectomy,LA)与开腹阑尾切除术(open appendectomy,OA)治疗小儿急性化脓性阑尾炎伴穿孔的临床疗效。回顾分析154例急性化脓性阑尾炎伴穿孔患儿的临床资料,其中85例行LA(LA组),69例行OA(OA组),对比两组手术时间、腹腔引流量、引流管留置时间、术后肠道排气时间、术后疼痛明显缓解时间、术后住院时间、住院费用、术后并发症总发生率、手术前后炎症指标等资料。结果显示,LA组在腹腔引流量、引流管留置时间、术后肠道排气时间、术后疼痛明显缓解时间、术后住院时间、术后并发症总发生率、术后炎症恢复情况等方面明显优于OA组,差异有统计学意义(P<0.05);而在手术时间、住院费用等方面LA组和OA组没有统计学差异。结果表明,与OA相比,小儿急性化脓性阑尾炎伴穿孔行LA具有创伤小、术后恢复快、并发症发生率低等优点,值得临床推广。

This paper compares the outcomes of laparoscopic appendectomy(LA)and open appendectomy(OA)in the treatment of acute suppurative appendicitis complicated perforation in children.A retrospective analysis was performed on 154 children with acute suppurative appendicitis complicated by perforation.Among them,69 patients were treated with OA,while 85 patients were treated with LA.We compared the hospitalization time,hospitalization cost,operation time,the time require for intestinal exhaust time and postoperative pain relief,indwelling time of drainage tube,drainage volume,postoperative complications,and inflammatory indicators before and after surgery in the two groups.The results show that the LA group is significantly better than the OA group in terms of hospitalization time,the time require for intestinal exhaust time and postoperative pain relief,indwelling time of drainage tube,drainage volume,complication rate and inflammation recovery(P<0.05).However,there is no statistical difference in terms of operation time and hospitalization costs between two groups.It is concluded that compared with OA,LA has the advantages of less trauma,faster postoperative recovery,and lower complication rate in the treatment of acute suppurative appendicitis complicated by perforation in children,which is worthy of further clinical application.