关于阑尾脓肿手术治疗体会

Experience in Surgical Treatment of Appendiceal Abscess

目的 探讨阑尾脓肿手术治疗体会。方法 择取2020年1月至2022年8月期间在我院行腹腔镜下阑尾周围脓肿清除阑尾切除术的60例患者为此次研究对象,均对患者实施腹腔镜下阑尾周围脓肿清除阑尾切除手术,并且在手术中使用超声刀辅助手术完成。观察患者的手术治疗效果。结果 60例阑尾脓肿患者经过此手术治疗干预后,手术均获得成功,且未出现术后出血、肠瘘脏器损伤及其他后遗症并发症等情况,患者的平均手术时间为(55.12±7.58)min,60例患者中有2例患者由于阑尾脓肿反复发作,脓肿形成时间太长,回盲部肠管粘连太严密,进行中转开腹手术,患者在术后无不良反应出现;患者的术后排气时间为(12.78±2.15)h,术后住院时间为(5.98±0.52)d;切口未出现感染,术后切口愈合良好。结论 阑尾脓肿在无心肺等重要脏器功能障碍,或合并存在凝血功能障碍等禁忌证情况下,应该尽早行腹腔镜下阑尾周围脓肿清除阑尾切除术,将超声刀应用于手术中的手术治疗效果良好,有利于避免患者在手术中、术后发生出血、脏器损伤肠瘘情况,明显降低患者发生并发症的风险,促进患者的术后恢复,减少住院时间及医疗费用。

Objective To explore the experience of surgical treatment of appendiceal abscess.Methods From January 2020 to August 2022,60 patients who underwent laparoscopic appendectomy for periappendiceal abscess in our hospital were selected as the research object.All patients underwent laparoscopic appendectomy for periappendiceal abscess,and the operation was assisted by ultrasonic scalpel.Observe the effect of surgical treatment.Results After this surgical intervention,60 patients with appendiceal abscess were successfully operated,and there were no cases of postoperative bleeding,intestinal fistula organ damage and other sequelae complications.The average operation time of the patients was(55.12±7.58) min.Two of the 60 patients had recurrent appendiceal abscesses,which took too long to form,and ileocecal intestinal adhesion was too tight.The patients were converted to open surgery in the middle,and there were no defects after the operation.The postoperative exhaust time was(12.78±2.15) h,and the postoperative hospitalization time was(5.98±0.52) d;No infection occurred in the incision,and the incision healed well after operation.Conclusion There is no important organ dysfunction such as heart and lung,or contraindications such as coagulation dysfunction,laparoscopic appendectomy for periappendiceal abscess should be performed as soon as possible.The application of ultrasonic scalpel in the operation has a good therapeutic effect,which is helpful to avoid bleeding and intestinal fistula caused by organ injury during and after the operation,obviously reduce the risk of complications,promote the postoperative recovery of patients,reduce the hospitalization time and medical expenses.