CAJ | 학술논문

目的探讨术前即刻超声定位阑尾指导阑尾切口，在小切口阑尾切除术中的应用价值。方法选择80例经B超检查已明确诊断为急性阑尾炎患者，随机分为观察组，对照组，每组各40例，行小切口阑尾切除术。观察组在B超检查时于腹壁相应体表投影位置标记阑尾根部，并在麻醉后术前再次标记，根据麻醉后标记的阑尾根部设计2～2.5 cm微小切口，测量前后定位距离。对照组不采用B超定位，微小切口经麦氏点或近压痛点。比较两组手术时间、术中出血量、排气时间、术后住院时间、并发症等。结果超声前后定位距离相差（1.90±0.61）cm，术前即刻超声定位阑尾与术中探查结果相符，且术前超声定位观察组平均手术时间优于未予超声定位的对照组（P＜0.05）；术中出血量、排气时间、术后住院时间、并发症等无明显差异。结论术前即刻超声定位更能准确反映阑尾位置，有利于术者在小切口阑尾切除术中快速找到阑尾，缩短手术时间。
목적탐토술전즉각초성정위란미지도란미절구，재소절구란미절제술중적응용개치。방법선택80례경B초검사이명학진단위급성란미염환자，수궤분위관찰조，대조조，매조각40례，행소절구란미절제술。관찰조재B초검사시우복벽상응체표투영위치표기란미근부，병재마취후술전재차표기，근거마취후표기적란미근부설계2～2.5 cm미소절구，측량전후정위거리。대조조불채용B초정위，미소절구경맥씨점혹근압통점。비교량조수술시간、술중출혈량、배기시간、술후주원시간、병발증등。결과초성전후정위거리상차（1.90±0.61）cm，술전즉각초성정위란미여술중탐사결과상부，차술전초성정위관찰조평균수술시간우우미여초성정위적대조조（P＜0.05）；술중출혈량、배기시간、술후주원시간、병발증등무명현차이。결론술전즉각초성정위경능준학반영란미위치，유리우술자재소절구란미절제술중쾌속조도란미，축단수술시간。
Objective To investigate the value of ultrasound locates the appendectomy and guide appendectomy incision in small incision appendectomy. Methods 80 patients with acute appendicitis that have been diagnosed by B ultrasound examination,were selected and randomly divided into the observation group and the control group. Each group was 40 cases and was given small incision appendectomy. In the observation group, corresponding appendix root was marked in the abdominal wall surface when B ultrasound examination was given, and after anesthesia marked again before surgery. A 2-2.5 cm minimal incision was designed, according to appendix after anesthesia marker, and positioning distance was measured. The control group did not use B ultrasound localization, minimal incision was McBurney point or near tenderness point. The operation time, bleeding volume, postoperative exhaust time and hospitalization time of two groups were compared. Results The distance between positioning before used Ultrasound and positioning after used Ultrasound was(1.90±0.61)cm. Appendix position of preoperative immediate ultrasound localization and intraoperative exploration results were consistent,and the average operation time of preoperative ultrasound localization in observation group was better than no ultrasound localization(P < 0.05).There were no significant differences in the amount of bleeding volume, postoperative exhaust time,hospitalization time and complications between two groups. Conclusion Preoperative immediate ultrasound can more accurately reflect the position of appendix,and the appendix can be quickly found in the small incision appendectomy to shorten the operation time.