中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2012年
12期
901-904
,共4页
腹腔镜检查%阑尾切除术%阑尾炎
腹腔鏡檢查%闌尾切除術%闌尾炎
복강경검사%란미절제술%란미염
Laparoscopy%Appendectomy%Appendicitis
目的 对比分析腹腔镜阑尾切除术(LA)和开腹阑尾切除术(OA)治疗小儿复杂性阑尾炎的疗效.方法 回顾性分析2004年5月至2010年12月收治的小儿复杂性阑尾炎1008例的临床资料,比较LA组和OA组手术时间、住院费用、腹腔脓肿及切口感染发生率.结果 两组均无手术死亡病例.LA组有24例中转开腹手术,Trocar孔/切口感染发生率(6.1％)较OA组(11.9％)低,差异有统计学意义(P=0.001).术后腹腔脓肿发生率LA组较OA组高(7.4％vs 3.7％),差异有统计学意义(P=0.011).LA组手术时间较OA组长[(54±12)min vs (53±14)min],且费用较OA组高[(7305±426)元vs (7255±435)元],但差异均无统计学意义(P=0.226,P=0.066).结论 LA具有创伤小、恢复快、并发症少、住院时间短等优点,是治疗小儿复杂性阑尾炎安全、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(LA)和開腹闌尾切除術(OA)治療小兒複雜性闌尾炎的療效.方法 迴顧性分析2004年5月至2010年12月收治的小兒複雜性闌尾炎1008例的臨床資料,比較LA組和OA組手術時間、住院費用、腹腔膿腫及切口感染髮生率.結果 兩組均無手術死亡病例.LA組有24例中轉開腹手術,Trocar孔/切口感染髮生率(6.1％)較OA組(11.9％)低,差異有統計學意義(P=0.001).術後腹腔膿腫髮生率LA組較OA組高(7.4％vs 3.7％),差異有統計學意義(P=0.011).LA組手術時間較OA組長[(54±12)min vs (53±14)min],且費用較OA組高[(7305±426)元vs (7255±435)元],但差異均無統計學意義(P=0.226,P=0.066).結論 LA具有創傷小、恢複快、併髮癥少、住院時間短等優點,是治療小兒複雜性闌尾炎安全、有效的手術方式,但術後腹腔膿腫髮生率偏高.
목적 대비분석복강경란미절제술(LA)화개복란미절제술(OA)치료소인복잡성란미염적료효.방법 회고성분석2004년5월지2010년12월수치적소인복잡성란미염1008례적림상자료,비교LA조화OA조수술시간、주원비용、복강농종급절구감염발생솔.결과 량조균무수술사망병례.LA조유24례중전개복수술,Trocar공/절구감염발생솔(6.1％)교OA조(11.9％)저,차이유통계학의의(P=0.001).술후복강농종발생솔LA조교OA조고(7.4％vs 3.7％),차이유통계학의의(P=0.011).LA조수술시간교OA조장[(54±12)min vs (53±14)min],차비용교OA조고[(7305±426)원vs (7255±435)원],단차이균무통계학의의(P=0.226,P=0.066).결론 LA구유창상소、회복쾌、병발증소、주원시간단등우점,시치료소인복잡성란미염안전、유효적수술방식,단술후복강농종발생솔편고.
Objective To compare the therapeutic efficacy of laparoscopic appendectomy (LA)with open appendectomy (OA) in children appendicitis complicated with gangrene,perforation and abscess.Methods Total 1008 case of children with appendicitis underwent laparoscopic (LA) (n =472)and open appendectomy (OA) (n =536) in our department between 2004 and 2010.The operative time,wound infection,postoperative intra-abdominal abscess and hospital expenses were targeted to evaluate in both groups.Results There was no mortality in both groups.24 cases of patients in LA group was converted to open procedure and wound (Trocar site) infection rate was significantly lower than that of OA group (6.1％ vs.11.9％,P =0.001).In term of postoperative intra-abdominal abscess,the incidence in LA group was higher than OA group (7.4％ vs.3.7％,P=0.011).Furthermore,the operation time in LA group was longer than OA group (54 ± 12 min vs.53 ± 14 min,P =0.226),and the hospital expenses was more expensive in LA group than in OA group (7305 ± 426RMB vs 7255 ± 435 RMB,P =0.066).Conclusions Laparoscopic appendectomy is a safe and beneficial operative procedure for children with appendicitis.The shorter hospital stay,fast recovery,low incidence of complication rate,as well as better cosmetics can be found in it.However,potential intraabdominal abscess needs to be prevented.
