腹腔镜辅助经脐小切口与常规腹腔镜手术治疗小儿急性单纯性阑尾炎的临床效果比较

Comparison of the clinical effect of laparoscopic assisted resection of acute appendicitis in children through small umbilical incision with conventional laparoscopic surgery

目的:比较腹腔镜辅助经脐小切口阑尾切除手术与常规三孔腹腔镜阑尾炎切除手术治疗小儿急性单纯性阑尾炎的临床效果。方法:回顾性分析自2020年1月—2022年5月连云港市妇幼保健院确诊急性单纯性阑尾炎并行手术切除治疗的136例患儿的临床资料。根据手术方式不同分为观察组与对照组。采用腹腔镜辅助经脐小切口阑尾切除手术患儿103例为观察组,采用常规三孔腹腔镜阑尾切除术患儿33例为对照组。比较分析两组患儿手术时间、术中出血、术后住院时长、住院费用。结果:两组患儿术后住院时长与手术费用比较,差异无统计学意义(P>0.05);观察组患儿的手术时间及术中出血量均少于对照组,差异有统计学意义(P<0.05);观察组术后并发症率(3.88%)低于对照组(15.15%),差异有统计学意义(P<0.05);术后观察组各炎症因子水平均低于对照组,差异有统计学意义(P<0.05);术前两组视觉模拟评分(VAS)比较,差异无统计学意义(P>0.05);术后2 d、术后4 d、术后7 d,观察组VAS评分低于对照组VAS评分,差异有统计学意义(P<0.05)。结论:相较于常规腹腔镜手术,腹腔镜辅助经脐小切口阑尾切除手术可明显缩短急性单纯性阑尾炎患儿手术时间,减少术中出血量,值得临床应用。

Objective To compare the clinical efficacy of laparoscopic assisted appendicitis resection through small umbilical incision with conventional laparoscopic surgery in the treatment of pediatric appendicitis.Methods The clinical data of 136 children with acute simple appendicitis diagnosed in Lianyungang Maternal and Child Health Hospital from January 2020 to May 2022 were retrospectively analyzed.According to different surgical methods,they were divided into observation group and control group.A total of 103 cases of children undergoing laparoscopic-assisted appendicectomy through small umbilical incision were selected as observation group,and 33 cases of children undergoing conventional three-hole laparoscopic appendectomy were selected as control group.The operation time,intraoperative bleeding,postoperative hospital stay and hospital expenses of the two groups were compared and analyzed.Results There was no significant difference in postoperative hospital stay duration and surgical cost between the two groups(P>0.05).The operation duration and intraoperative blood loss in the observation group were less than those in the control group(P<0.05).The postoperative complication rate of the observation group(3.88%)was lower than that of the control group(15.15%)(P<0.05).Comparison of inflammatory factors:The levels of inflammatory factors in the observation group were lower than those in the control group after surgery(P<0.05).There was statistically non-significant(P>0.05)between the two groups in preoperative Visual Analogue Scale(VAS)score;The VAS score of the observation group was lower than that of the control group at 2 d,4 d and 7 d after surgery(P<0.05).Conclusions Compared with conventional laparoscopic surgery,laparoscopic assisted transumbilical small incision appendectomy can significantly shorten the operation time and reduce the amount of intraoperative bleeding in children with acute simple appendicitis,which is worthy of clinical promotion and application.