中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2013年
24期
17-19
,共3页
急性阑尾炎%手术切除%安全性
急性闌尾炎%手術切除%安全性
급성란미염%수술절제%안전성
Acute appendicitis%Appendectomy%Safety
目的：探讨小儿急性阑尾炎行手术切除的时机、疗效及安全性。方法我院2007年9月~2013年9月间收治的急性阑尾炎患儿126例，对其临床资料进行分析总结。按照手术时间分为A组（3d内手术）73例，B组（4~7d手术）34例、C组（8d及以上手术）19例。结果126例患儿中行单纯阑尾切除术者92例，其中行腹腔镜手术者73例，行开腹手术者19例，行阑尾切除加腹腔引流者34例，其中行腹腔镜手术者20例，行开腹手术者14例；A组和B组患儿手术时间、肠道恢复时间及住院时间均短于C组（tAC=2.967，P=0.0387；tBC=2.637，P=0.0459）；A组患儿并发症发生率5.48%（4/73），B组患儿并发症发生率14.71%，C组患儿并发症发生率42.11%（8/19），A组及B组患儿术后并发症发生率明显低于C组患儿（x2AC=4.369，P=0.0252；x2BC=3.697，P=0.0351）；术后C组患儿CRP、IL-6及TNF-α水平均明显高于A组和B组患儿（tAC=3.098，P=0.0395；tBC=2.581，P=0.0439）。结论小儿急性阑尾炎确诊后应及时行手术治疗，早期手术治疗效果更佳，腹腔镜手术用于小儿急性阑尾炎中同样安全有效，但对手术操作技术有一定要求，临床应综合考虑患儿病情、手术条件等确定具体的手术方案，以减少手术损伤。
目的：探討小兒急性闌尾炎行手術切除的時機、療效及安全性。方法我院2007年9月~2013年9月間收治的急性闌尾炎患兒126例，對其臨床資料進行分析總結。按照手術時間分為A組（3d內手術）73例，B組（4~7d手術）34例、C組（8d及以上手術）19例。結果126例患兒中行單純闌尾切除術者92例，其中行腹腔鏡手術者73例，行開腹手術者19例，行闌尾切除加腹腔引流者34例，其中行腹腔鏡手術者20例，行開腹手術者14例；A組和B組患兒手術時間、腸道恢複時間及住院時間均短于C組（tAC=2.967，P=0.0387；tBC=2.637，P=0.0459）；A組患兒併髮癥髮生率5.48%（4/73），B組患兒併髮癥髮生率14.71%，C組患兒併髮癥髮生率42.11%（8/19），A組及B組患兒術後併髮癥髮生率明顯低于C組患兒（x2AC=4.369，P=0.0252；x2BC=3.697，P=0.0351）；術後C組患兒CRP、IL-6及TNF-α水平均明顯高于A組和B組患兒（tAC=3.098，P=0.0395；tBC=2.581，P=0.0439）。結論小兒急性闌尾炎確診後應及時行手術治療，早期手術治療效果更佳，腹腔鏡手術用于小兒急性闌尾炎中同樣安全有效，但對手術操作技術有一定要求，臨床應綜閤攷慮患兒病情、手術條件等確定具體的手術方案，以減少手術損傷。
목적：탐토소인급성란미염행수술절제적시궤、료효급안전성。방법아원2007년9월~2013년9월간수치적급성란미염환인126례，대기림상자료진행분석총결。안조수술시간분위A조（3d내수술）73례，B조（4~7d수술）34례、C조（8d급이상수술）19례。결과126례환인중행단순란미절제술자92례，기중행복강경수술자73례，행개복수술자19례，행란미절제가복강인류자34례，기중행복강경수술자20례，행개복수술자14례；A조화B조환인수술시간、장도회복시간급주원시간균단우C조（tAC=2.967，P=0.0387；tBC=2.637，P=0.0459）；A조환인병발증발생솔5.48%（4/73），B조환인병발증발생솔14.71%，C조환인병발증발생솔42.11%（8/19），A조급B조환인술후병발증발생솔명현저우C조환인（x2AC=4.369，P=0.0252；x2BC=3.697，P=0.0351）；술후C조환인CRP、IL-6급TNF-α수평균명현고우A조화B조환인（tAC=3.098，P=0.0395；tBC=2.581，P=0.0439）。결론소인급성란미염학진후응급시행수술치료，조기수술치료효과경가，복강경수술용우소인급성란미염중동양안전유효，단대수술조작기술유일정요구，림상응종합고필환인병정、수술조건등학정구체적수술방안，이감소수술손상。
Objective To investigate the operation timing, efficacy and safety of appendectomy in children with acute appendicitis. Methods Clinical data of 126 children with acute appendicitis admitted in our hospital from September 2011 to September 2013 was retrospectively analyzed.According to operative time, all the cases were divided into group A with 73 cases (no more than 3 days),group B with 34 cases (4 to 7 days),and group C with 19 cases(beyond 8 days). Results Among 126 patients,92 patients received appendectomy,including 73 cases of laparoscopic appendectomy and 19 cases of open appendectomy.34 patients received peritoneal drainage and appendectomy, including 20 cases of laparoscopic appendectomy and 14 cases of open appendectomy.The operation time,recovery time of bowel function and hospital stay in group A and B were shorter than those in group C (tAC=2.967,P=0.0387;tBC=2.637,P=0.0459).The complication rates in group A,B and C were 5.48% (4/73),14.71% and 42.11% (8/19) respectively.The complication rate after operation in group A and B was significantly lower than that in group C (x2AC=4.369,P=0.0252;x2BC=3.697,P=0 .0351).The CRP, IL-6 and TNF-αlevels in group C were significantly higher than those in group A and B(tAC=3.098, P=0.0395;tBC=2.581,P=0.0439). Conclusion Once children are diagnosed with acute appendicitis, prompt operation should be performed with a better outcome. Laparoscopic appendectomy is also an effective and safe method in treating children with acute appendicitis,but it has higher requirement for the surgical techniques.Proper surgical method should be performed considering the patients'condition and operation condition to minimize the surgical trauma.
