中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
3期
207-209
,共3页
阑尾炎%腹腔镜%阑尾切除术
闌尾炎%腹腔鏡%闌尾切除術
란미염%복강경%란미절제술
Appendicitis%Laparoscopes%Appendectomy
目的 对比分析腹腔镜阑尾切除术(laparoscopic appendectomy,LA)和开腹阑尾切除术( open appendectomy,OA)治疗伴有坏疽、穿孔及阑尾周围脓肿的儿童阑尾炎的疗效.方法 回顾性分析614例儿童复杂性阑尾炎患者的临床资料,比较LA组(267例)和OA组(347例)手术时间、住院时间、住院费用及术后并发症的发生率.结果 本组614例患者中无手术死亡发生,LA组有7例中转开腹手术,LA组术后住院时间较OA组短(4.6d比8.1d,P=0.00),Trocar孔或切口感染(5.3％比12.8％,P=0.03)、肠梗阻(5.0％比10.0％,P=0.04)及院内感染发生率(9.7％比18.3％,P=0.04)均较OA组低.术后LA组腹腔脓肿发生率较OA组高(4.1％比1.1％,P=0.04),差异有统计学意义.两组的手术时间及费用之间比较差异无统计学意义(均P＞0.05).结论 LA具有创伤小、恢复快、并发症少、住院时间短等优点,是治疗儿童复杂性阑尾炎一种安全有效的手术方式,但术后腹腔脓肿发生率偏高.
目的 對比分析腹腔鏡闌尾切除術(laparoscopic appendectomy,LA)和開腹闌尾切除術( open appendectomy,OA)治療伴有壞疽、穿孔及闌尾週圍膿腫的兒童闌尾炎的療效.方法 迴顧性分析614例兒童複雜性闌尾炎患者的臨床資料,比較LA組(267例)和OA組(347例)手術時間、住院時間、住院費用及術後併髮癥的髮生率.結果 本組614例患者中無手術死亡髮生,LA組有7例中轉開腹手術,LA組術後住院時間較OA組短(4.6d比8.1d,P=0.00),Trocar孔或切口感染(5.3％比12.8％,P=0.03)、腸梗阻(5.0％比10.0％,P=0.04)及院內感染髮生率(9.7％比18.3％,P=0.04)均較OA組低.術後LA組腹腔膿腫髮生率較OA組高(4.1％比1.1％,P=0.04),差異有統計學意義.兩組的手術時間及費用之間比較差異無統計學意義(均P＞0.05).結論 LA具有創傷小、恢複快、併髮癥少、住院時間短等優點,是治療兒童複雜性闌尾炎一種安全有效的手術方式,但術後腹腔膿腫髮生率偏高.
목적 대비분석복강경란미절제술(laparoscopic appendectomy,LA)화개복란미절제술( open appendectomy,OA)치료반유배저、천공급란미주위농종적인동란미염적료효.방법 회고성분석614례인동복잡성란미염환자적림상자료,비교LA조(267례)화OA조(347례)수술시간、주원시간、주원비용급술후병발증적발생솔.결과 본조614례환자중무수술사망발생,LA조유7례중전개복수술,LA조술후주원시간교OA조단(4.6d비8.1d,P=0.00),Trocar공혹절구감염(5.3％비12.8％,P=0.03)、장경조(5.0％비10.0％,P=0.04)급원내감염발생솔(9.7％비18.3％,P=0.04)균교OA조저.술후LA조복강농종발생솔교OA조고(4.1％비1.1％,P=0.04),차이유통계학의의.량조적수술시간급비용지간비교차이무통계학의의(균P＞0.05).결론 LA구유창상소、회복쾌、병발증소、주원시간단등우점,시치료인동복잡성란미염일충안전유효적수술방식,단술후복강농종발생솔편고.
Objective To compare laparoscopic appendectomy (LA) with open appendectomy (OA) in the treatment of appendicitis complicating gangrene,perforation and abscess in children.Methods This study included 614 consecutively admitted patients with acute complicated appendicitis undergoing laparoscopic (267 cases) or open (347 cases) appendectomy.Clinical outcomes were compared between the 2 groups in relation to operative time,length of hospital stay,postoperative complications and in hospital cost. Results There was no mortality.Conversion to open surgery was necessary in 7 patients in LA group.Laparoscopic appendectomy was associated with a shorter hospital stay (4.6 d vs.8.1 d,P =0.00),lower incidence of wound infection(5.3％ vs.12.8％,P =0.03),less bowel obstruction(5.0％vs.10.0％,P =0.04) and nosocomial infection (9.7％ vs.18.3％,P =0.04).Intra-abdominal abscess formation was significantly higher after laparoscopic surgery (4.1％ vs.1.1％,P =0.04 ).The cost of treatment and operative time were higher in the laparoscopic group than in open appendectomy,however,there was no statistically significant difference. Conclusions Laparoscopic technique is a safe and clinically beneficial operative procedure for complicated appendicitis in children with short hospital stay,early recovery,good cosmetic appearance,and low complication rate,except for a higher incidence of intraabdominal abscess.
