CAJ | 학술논문

目的：腹腔镜逆行阑尾切除术中超声刀与电刀的作用进行对照比较分析，探讨超声刀的优越性。方法回顾分析总结2007-2013年逆行阑尾切除术中使用超声刀的38例及使用电刀的44例临床资料进行对比分析。结果平均手术时间超声刀组为（43.05±3.65）min，电刀组为（47.25±6.36）min，与电刀组相比超声刀组手术时间显著下降（P <0.01）。出血量分别为（3.51±1.05）ml、（10.05±2.33）ml，超声刀组显著低于电刀组（P <0.01）。超声刀组无开腹病例，术后无肠梗阻发生，电刀组开腹7例，术后肠梗阻3例，两组间差异有统计学意义（P <0.01）。结论超声刀在腹腔镜逆行阑尾切除中具有创伤小、手术时间短、并发症少等优点，切割止血、手术操作安全性方面超声刀应用效果优于电刀。
목적：복강경역행란미절제술중초성도여전도적작용진행대조비교분석，탐토초성도적우월성。방법회고분석총결2007-2013년역행란미절제술중사용초성도적38례급사용전도적44례림상자료진행대비분석。결과평균수술시간초성도조위（43.05±3.65）min，전도조위（47.25±6.36）min，여전도조상비초성도조수술시간현저하강（P <0.01）。출혈량분별위（3.51±1.05）ml、（10.05±2.33）ml，초성도조현저저우전도조（P <0.01）。초성도조무개복병례，술후무장경조발생，전도조개복7례，술후장경조3례，량조간차이유통계학의의（P <0.01）。결론초성도재복강경역행란미절제중구유창상소、수술시간단、병발증소등우점，절할지혈、수술조작안전성방면초성도응용효과우우전도。
Objective To identify whether it has advantage of ultracision harmonic scalpel over high frequency electrotome in laproscopic retrograde appendectomy. Methods We analyzed the clinical data of 82 patients in our hospital from 2007 to 2013. Analysis of operative duration,mean bleeding,postoperative intestinal obstruction and convertion to open laparotomy were performed respectively to set forth the difference between the group of ultracision harmonic scalpel and group of high frequency electrotome by retrospective study. Results The operative duration were 43. 05 ± 3. 65 min in the group of ultracision harmonic scalpel, and 43. 05 ± 3. 65 min in the group of high frequency electrotome. The volume and time were remarkably descendent in the group of ultracision harmonic scalpel comparing to the group of high frequency electrotome (P < 0. 01). mean bleeding were(3. 51 ± 1. 05)ml,(10. 05 ± 2. 33)ml respectively,which was remarkably descendent in the group of ultracision harmonic scalpel comparing to the group of high frequency electrotome(P < 0. 01). There was no postoperative intestinal obstruction and convertion to open laparotomy in the group of ultracision harmonic scalpel,7 patients required convertion to open laparotomy,3 patients happened postoperative intestinal obstruction,there was significant difference between the group of ultracision harmonic scalpel and the group of high frequency electrotome(P < 0. 01). Conclusion We found that usage of ultracision harmonic scalpel in laproscopic retrograde appendectomy can reduce the operative duration and the risk of bleeding. Moreover,the group of ultracision harmonic scalpel had lower incidence of convertion to open laparotomy and postoperative intestinal obstruction. Our study demonstrated that using ultracision harmonic scalpel in laproscopic retrograde appendectomy is a safe,effective,less traumat and complication surgery procedure.