CAJ | 학술논문

目的对比分析腹腔镜和开腹手术治疗急性阑尾炎的手术效果和优缺点.方法将1558例急性阑尾炎患者分为腹腔镜组(779例)和开放组(779例),比较两组手术的临床指标及术后随访情况.采用SPSS11.5软件,计量资料采用t检验,计数资料采用X~2检验.结果两组手术均顺利完成.腹腔镜组和开放组手术时间分别为(30±2.2)min和(30±1.6)min(t=0.00,P>0.05);术中出血量分别为(15±2.9)ml及(29±5.2)ml(t=65.62,P<0.05);术后下床活动时间分别为(26±3.1)h及(51±2.1)h(t=69.95,P<0.05);术后排气时间分别为(29±1.6)h及(52±4.6)h(t=10.92,P<0.05);住院时间分别为(3±0.9)d及(7±1.2)d(t=74.42,P<0.05);综合费用分别为(6591±41)元及(4860±32)元(t=-12.19,P<0.05);切口感染率分别为0及2.8%(X~2=25.40,P<0.05);止痛药使用频率分别为3.8%和31.4%(X~2=30.63,P<0.05).随访时间为4.5～9.8(平均6.8)年,切口疝的发生率分别为0及0.64%(X~2=5.01,P<0.05).结论腹腔镜手术治疗急性阑尾炎具有创伤小、恢复快、并发症少和平均住院时间短等优点,是治疗急性阑尾炎较为理想的手术方式.
목적 대비분석복강경화개복수술치료급성란미염적수술효과화우결점.방법 장1558례급성란미염환자분위복강경조(779례)화개방조(779례),비교량조수술적림상지표급술후수방정황.채용SPSS11.5연건,계량자료채용t검험,계수자료채용X~2검험.결과 량조수술균순리완성.복강경조화개방조수술시간분별위(30±2.2)min화(30±1.6)min(t=0.00,P>0.05);술중출혈량분별위(15±2.9)ml급(29±5.2)ml(t=65.62,P<0.05);술후하상활동시간분별위(26±3.1)h급(51±2.1)h(t=69.95,P<0.05);술후배기시간분별위(29±1.6)h급(52±4.6)h(t=10.92,P<0.05);주원시간분별위(3±0.9)d급(7±1.2)d(t=74.42,P<0.05);종합비용분별위(6591±41)원급(4860±32)원(t=-12.19,P<0.05);절구감염솔분별위0급2.8%(X~2=25.40,P<0.05);지통약사용빈솔분별위3.8%화31.4%(X~2=30.63,P<0.05).수방시간위4.5～9.8(평균6.8)년,절구산적발생솔분별위0급0.64%(X~2=5.01,P<0.05).결론 복강경수술치료급성란미염구유창상소、회복쾌、병발증소화평균주원시간단등우점,시치료급성란미염교위이상적수술방식.
Objective To compare laparoscopic appendectomy to conventional operation for the treatment of appendicitis.Methods In this study 1558 patients diagnosed as appendicitis were divided into group A(laparoscopic appendectomy)and group B(conventional operation)according to the random numbers.In group A,779 patients were treated with laparoscopic appendectomy.In group B,779 patients were treated with conventional open appendectomy.The inhospital data and that of followed-up were compared.Statistical analysis was carried out using SPSS11.5 for Windows.Comparisons between categorical variables and continuous variables were analyzed using the X~2 test and t test.Results The operation was successfully performed in all 1558 patients.The operating time in group A and B were(30±2.2)min versus(30±1.6)min(t=0.00,P>0.05),the blood loss were(15±2.9)ml versus(29±5.2)ml(t=65.62,P<0.05),the bed off activity time were(26±3.1)h versus(51±2.1)h(t=69.95,P<0.05),the bowels'move time were(29±1.6)h versus(52±4.6)h(t=10.92,P<0.05),the hospital stay were(3±0.9)d versus(7±1.2)d(t=74.42,P<0.05),the inhospital cost was (6591±41)yuan versus(4860±32)yuan(t=-12.19,P<0.05),the incision infection rate was 0 and 2.8%(X~2=25.40,P<0.05).Postoperative analgesics were needed in 3.8% and 31.4% (X~2=30.63,P<0.05).All the patients were followed-up from 4.5 years to 9.8 years(average 6.8 years).The development of incision hernia in group A and B was 0 versus 0.64% (X~2=5.01,P<0.05).Conclusions Laparoscopic appendectomy is a therapy of choice for patients with acute appendicitis with advantages of minimal invasion,early recovery,few complications and short hospital stay.