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腹腔镜下阑尾切除术与开腹阑尾切除术治疗急性阑尾炎的效果对比(1)
http://www.100md.com 2017年11月5日 中外医疗 2017年第31期
     [摘要] 目的 研究腹腔镜阑尾切除术与开腹阑尾切除术治疗急性阑尾炎的疗效。方法 于2016年5月—2017年7月来该院普外科就诊的急性阑尾炎患者中方便选取选出74例,根据手术方法不同分组,对照组患者行开腹阑尾切除术;观察组患者行腹腔镜阑尾切除术。结果 观察组患者的手术时间[(40.2±6.50 min vs (39.5±6.80)min]与对照组比较差异无统计学意义(P>0.05);在术中出血量[(11.6±2.30)mL vs (24.3±4.20)mL]、术后下床活动时间[(0.84±0.15)d vs (1.26±0.24)d]、肛门排气时间[(0.97±0.19)d vs (1.44±0.28 d)]、进食时间[(1.04±0.13)d vs (1.48±0.25)d]、住院时间[(4.76±0.25)d vs (6.92±0.33)d]指标上,观察组均优于对照组(P<0.01);观察组患者的术后并发症发生率5.41%低于对照组的21.62%(P<0.05)。结论 腹腔镜阑尾切除术用于急性阑尾炎治疗中效果确切,手术的创伤、应激反应小,患者术后恢复较快。

    [关键词] 腹腔镜阑尾切除术;开腹阑尾切除术;急性阑尾炎

    [中图分类号] R656 [文献标识码] A [文章编号] 1674-0742(2017)11(a)-0065-03

    [Abstract] Objective To research the curative effect of laparoscopic appendectomy and open appendectomy in treatment of acute appendicitis. Methods 74 cases of patients with acute appendicitis diagnosed in our hospital from May 2016 to July 2017 were conveniently selected and divided into two groups according to different operation methods, the control group and the observation group were respectively treated with laparoscopic appendectomy and open appendectomy. Results The difference in the operation time between the observation group and the control group was not obvious,[(40.2±6.50)min vs(39.5±6.80)min](P>0.05), and the intraoperative bleeding amount, time to get out of bed after surgery, anal exhaust time, eating time and length of stay in the observation group were better than those in the control group,[(11.6±2.30)mL vs (24.3±4.20)mL, (0.84±0.15)d vs (1.26±0.24)d, (0.97±0.19)d vs (1.44±0.28)d, (1.04±0.13)d vs (1.48±0.25)d, (4.76±0.25)d vs (6.92±0.33)d](P<0.01), and the incidence rate of postoperative complications in the observation group was lower than that in the control group (5.41% vs 21.62%)(P<0.05). Conclusion The effect of laparoscopic appendectomy in treatment of acute appendicitis is definite with small operation wound and stress reaction, and the recovery of patients is rapid.

    [Key words] Laparoscopic appendectomy; Open appendectomy; Acute appendicitis

    阑尾切除术是目前临床上治疗急性阑尾炎的主要方法,其中传统的开腹手术由于对患者造成较大创伤,患者术后的生理应激反应较重,故而患者术后恢复相对较慢[1-2]。微创医学的发展、腹腔镜技术的进步使得腹腔镜阑尾切除术在临床上得到大力推广。现回顾性分析该院2016年5月—2017年7月收治的74例急性阑尾患者的临床资料,探索腹腔镜手术与开腹手术的疗效差异。

    1 资料与方法

    1.1 一般资料

    回顾性分析并方便选取该院收治的74例急性阑尾炎患者临床资料,全部患者均接受阑尾切除术治疗,均经相关实验室检查等予以确诊,排除妊娠期哺乳期女性,排除严重脏器功能病变、合并慢性炎症、糖尿病等疾病的患者。根据手术方法不同分组,对照组患者37例,男17例,女20例,年龄在22~69岁,平均(41.2±8.6)岁;单纯性阑尾炎16例,化脓性阑尾炎10例,坏疽性闌尾炎11例。观察组患者37例,男20例,女17例,年龄在24~71岁,平均(41.7±8.5)岁;单纯性阑尾炎18例,化脓性阑尾炎10例,坏疽性阑尾炎9例。两组患者的基础资料差异无统计学意义,有可比性。, http://www.100md.com(郑斐燏)
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