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中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (06) : 483 -486. doi: 10.3877/cma.j.issn.1674-0793.2015.06.016

所属专题: 文献

论著

腹腔镜阑尾切除术的疗效及对并发症的影响
沈韧斌1,(), 朱建华1, 袁政1   
  1. 1. 215000 南京医科大学附属苏州医院(苏州市立医院本部)普外科
  • 收稿日期:2015-08-11 出版日期:2015-12-01
  • 通信作者: 沈韧斌

Efficacy and complications of laparoscopic appendectomy

Renbin Shen1,(), Jianhua Zhu1, Zheng Yuan1   

  1. 1. Department of General Surgery, Suzhou Hospital Affiliated to Nanjing Medical University, Main Building of Suzhou Municipal Hospital, Suzhou 215000, China
  • Received:2015-08-11 Published:2015-12-01
  • Corresponding author: Renbin Shen
  • About author:
    Corresponding author: Shen Renbin, Email:
引用本文:

沈韧斌, 朱建华, 袁政. 腹腔镜阑尾切除术的疗效及对并发症的影响[J/OL]. 中华普通外科学文献(电子版), 2015, 09(06): 483-486.

Renbin Shen, Jianhua Zhu, Zheng Yuan. Efficacy and complications of laparoscopic appendectomy[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(06): 483-486.

目的

比较腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)治疗急阑尾炎的临床疗效及并发症。

方法

选择2014年1月至2015年5月收治的拟行阑尾切除术的阑尾炎患者118例,将患者随机分为试验组和对照组,每组59例,试验组采用LA术,对照组采用OA术,比较两组患者的临床效果及并发症发生情况,评价急性和慢性阑尾炎行腹腔镜手术的效果。

结果

与对照组比较,试验组的手术时间延长,而住院时间、术后首次下床、排气及进食时间均明显缩短,24 h镇痛药物使用率也显著减少,住院费用明显增加(t=14.342、6.916、4.166、9.527、8.036,χ2=5.950,t=32.663,P<0.05)。试验组中急性阑尾炎患者34例,与25例慢性阑尾炎患者比较,手术时间、住院时间、术后首次排气及进食时间均明显延长,术中出血量明显增加(t=8.195、1.776、5.329、4.337、3.757,P<0.05)。试验组术后24 h、48 h时白细胞(WBC)、C反应蛋白(CRP)水平均显著低于对照组(P<0.05);伤口感染、腹腔脓肿的发生率及总发生率显著低于对照组(χ2=4.827、4.140、10.602,P<0.05)。

结论

LA治疗急性及慢性阑尾炎均安全有效,可减少术后并发症,促进术后恢复。

Objective

To compare the efficacy and complications between laparoscopic appendectomy (LA) and open appendectomy (OA).

Methods

One hundred and eighteen appendicitis patients undergoing appendectomy were chosen from January 2014 to May 2015. All the cases were divided into the trial group (59 cases, received LA) and the control group (59 cases, received OA). The clinical efficacy and complications of two groups and the outcome of LA for acute and chronic appendicitis were compared.

Results

Compared with control group, the operation time increased in the trial group, while hospital stay, postoperative first bed-off time, passing flatus, and first food-taking shortened; usage of anesthetics within 24 h reduced, and hospitalization expenses increased (t=14.342, 6.916, 4.166, 9.527, 8.036, χ2=5.950, t=32.663, P<0.05). In the trial group, compared with 25 cases with chronic appendicitis, the other 34 cases with acute appendicitis had longer operation time, hospital stay, time of postoperative first passing flatus and first food-taking, more intraoperative blood loss (t=8.195, 1.776, 5.329, 4.337, 3.757, P<0.05). The levels of WBC, CRP at 24 h, 48 h after operation in the trial group were significantly lower than those in control group (P<0.05). The incidence of wound infection, celiac abscess and total incidence in experimental group were significantly lower than those in control group (χ2=4.827, 4.140, 10.602, P<0.05).

Conclusion

LA is safe and effective in the treatment of acute and chronic appendicitis, which can reduce the postoperative complications and promote postoperative recovery.

表1 两组手术临床疗效指标比较
表2 试验组急性与慢性阑尾炎患者LA临床疗效比较
表3 两组患者手术前后WBC、CRP变化比较( ± s, t检验)
表4 两组患者术后并发症发生情况比较[例(%)]
1
毛常青, 曹清勇, 曾志民, 等. 小儿腹腔镜阑尾切除术CO2气腹对呼吸的影响[J]. 中华普通外科杂志, 2013, 12(1): 58-59.
2
Jeong JS, Ryu DH, Yun HY, et al. Laparoscopic appendectomy is a safe and beneficial procedure in pregenant women[J]. Surg Laparosc Endosc Percutan Tech, 2011, 21(1): 24-27.
3
司徒升, 余建雄, 周沛华, 等. 腹腔镜阑尾切除术术中阑尾系膜的不同处理方式[J/CD]. 中华腔镜外科杂志:电子版, 2011,4(1): 29-32.
4
Bouasker I, El Ouaer MA, Smaali I, et al. Laparoscopic cholecystectomy on a previously operated abdomen[J]. Tunis Med, 2010, 88(2): 88-91.
5
何欢, 张抒, 李云涛, 等. 腹腔镜与开腹阑尾切除术的系统评价[J]. 中国普外基础与临床杂志, 2012, 5(19): 538-540.
6
吴辉. C反应蛋白、白细胞计数和中性粒细胞联合检测对急性阑尾炎诊断的临床应用价值[J]. 中国实用医药, 2013, 8(27): 62-63.
7
张春侠, 章来长,赵胤铭.单孔双视免气腹腔镜与传统阑尾切除术的对比研究[J/CD]. 中华腔镜外科杂志:电子版, 2014, 7(5): 404-406.
8
范钦忠, 李联强, 张鸿鹇. 腹腔镜阑尾切除术残端包埋技巧及临床应用[J/CD]. 中华腔镜外科杂志:电子版, 2012, 5(2): 136-138.
9
Markides G, Subar D, Riyad K. Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis[J]. World J Surg, 2010, 31(4): 2026-2040.
10
Bozkurt MA, Unsal MG, Kapan S, et al. Is laparoscopic appendectomy going to be standard procedure for acute appendicitis: a 5-year single center experience with 1,788 patients[J]. Eur J Trauma Emerg Surg, 2015, 41(1): 87-89.
[1
舒思远, 喻登明, 张正伟. 腹腔镜阑尾切除术中递进的术式选择[J/CD]. 中华普通外科学文献:电子版, 2010, 4(3): 265-266.
12
滕廷鹏, 张春皎, 李胜, 等. 腹腔镜与开腹手术治疗成人急性阑尾炎的Meta分析[J]. 中国全科医学, 2012, 15 (8): 2670.
13
Frutos MD, Abrisqueta J, Lujan J, et al. Randomized prospective study to compare laparoscopic appendectomy versus umbilical single-incision appendectomy[J]. Ann Surg, 2013, 257(3): 413-418.
14
王有利, 刘凡, 叶颖江, 等. 腹腔镜阑尾切除术在急性和慢性阑尾炎中应用疗效的比较[J]. 中华普通外科杂志, 2013, 28(2): 93-95.
15
Sporn E, Petroski GF, Mancini GJ, et al. Laparroscopic appendectomy is it worth the cost? Trend analysis in the US from 2000 to 2005[J]. J Am Coll Surg, 2009, 208(2): 179-185.
16
马博, 杨旭, 任菲. 腹腔镜阑尾切除术与开腹阑尾切除术在治疗老年患者中的临床疗效比较[J]. 现代预防医学, 2012, 39(16): 4314-4315.
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