行腹腔镜与开腹手术治疗复杂性阑尾炎的疗效及安全性比较

Comparison of Efficacy and Safety of Laparoscopy and Open Surgery for Treating Complicated Appendicitis

目的:比较腹腔镜与开腹阑尾切除术治疗小儿复杂性阑尾炎的疗效及安全性。方法:选取2016年3月—2017年3月我院收治的90例复杂性阑尾炎患儿为研究对象,根据手术方式不同分为腹腔镜组(腹腔镜阑尾切除术治疗)48例和开腹组(开腹阑尾切除术治疗)42例。比较两组临床指标、切口感染等其他并发症发生情况及视觉模拟评分(VAS)。结果 :腹腔镜组术中出血量少于开腹组,术后肠功能恢复时间和住院时间短于开腹组,差异有统计学意义(P<0.05);腹腔镜组切口感染、腹腔脓肿发生率低于开腹组(P<0.05);术后3 d腹腔镜组VAS评分低于开腹组(P<0.05)。结论 :与开腹阑尾切除术比较,腹腔镜阑尾切除术治疗小儿复杂性阑尾炎疗效更优,安全性更高,预后更好,具有临床推广应用价值。

Objective: To compare the efficacy and safety of laparoscopy and open appendectomy for treating pediatric complicated appendicitis. Methods: 90 children with complicated appendicitis admitted to our hospital from March 2016 to March 2017 were selected as subjects investigated and divided into laparoscopy group(laparoscopic appendectomy, n=48) and open surgery group(open appendectomy, n=42) according to different surgical methods. Clinical indexes, incidence of other complications such as wound infection and visual analogue scale(VAS) were compared between the two groups. Results: The amount of bleeding in the laparoscopy group was significantly less than that in the open surgery group, and the recovery time and hospitalization time were significantly shorter than those in the open surgery group(P<0.05). The incidence of incision infection and abdominal abscess in the laparoscopy group was lower than that in the open surgery group(P<0.05). The VAS scores 3 days after surgery in the laparoscopy group were lower than those in the open surgery group(P<0.05). Conclusion: Compared with open appendectomy, laparoscopic appendectomy is more effective in treating pediatric complicated appendicitis, and has higher safety, better prognosis and clinical application value.