腹腔镜治疗伴有坏疽、穿孔及阑尾周围脓肿的复杂性阑尾炎的优势探讨

Laparoscopic Treatment of complicated appendicitis with gangrene,Perforation and periappendiceal abscess

目的探究腹腔镜手术在伴有坏疽、穿孔、阑尾周围脓肿的复杂性阑尾炎治疗中的优势。方法回顾性收集我院普外科2017年1月~2018年5月收治的120例复杂性阑尾炎患者的临床资料,回顾手术方法分入腹腔镜组和开腹组,整理两组的手术治疗效果。结果两组手术时间、术后恢复正常饮食时间对比差异不明显,P>0.05;腹腔镜组的切口长度、术后胃肠道功能恢复正常时间、术后住院时间均少于开腹组,P <0.05;两组术后并发症发生率比较差异无统计学意义,其中肠梗阻和腹腔脓肿发生率差异不明显,P>0.05;但腹腔镜组的术后切口感染发生率低于开腹组,P <0.05。结论在伴有坏疽、穿孔、阑尾周围脓肿的复杂性阑尾炎治疗中,腹腔镜手术对患者创伤小,利于术后康复,有效减少术后切口感染发生,且并不会增加腹腔脓肿发生风险,具有推广价值。

Objective To explore the advantages of laparoscopic surgery in the treatment of complicated appendicitis with gangrene,perforation and periappendiceal abscess.Methods The clinical data of 120 patients with complicated appendicitis admitted in the Department of general surgery of our hospital in January 2017 to May 2018 were collected retrospectively.The surgical methods were divided into laparoscopy group and laparotomy group,and the effect of two groups was sorted.Results There was no significant difference between the two groups of operation time and the normal diet time after operation,P>0.05.The length of the incision in the laparoscope group,the normal time for the recovery of the gastrointestinal function and the time of postoperative hospitalization were less than that of the open group,P<0.05.There was no significant difference in the incidence of postoperative complications in the two groups,in which the intestinal obstruction and the intestinal obstruction were not statistically significant.The incidence of abdominal abscess was not significantly different,P>0.05,but the incidence of incision infection in laparoscopic group was lower than that in laparotomy group,P<0.05.ConclusionIn the treatment of complicated appendicitis with gangrene,perforation,and periappendiceal abscess,laparoscopy is less invasive to patients,is beneficial to postoperative rehabilitation,effectively reduces postoperative infection of incision,and does not increase the risk of abdominal abscess,which is of promotion value.