中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
2期
93-95
,共3页
王有利%刘凡%叶颖江%申占龙%尹慕军%姜可伟%王杉
王有利%劉凡%葉穎江%申佔龍%尹慕軍%薑可偉%王杉
왕유리%류범%협영강%신점룡%윤모군%강가위%왕삼
阑尾炎%阑尾切除术%腹腔镜检查
闌尾炎%闌尾切除術%腹腔鏡檢查
란미염%란미절제술%복강경검사
Appendicitis%Appendectomy%Laparoscopes
目的 通过探讨腹腔镜阑尾切除术在治疗急性和慢性阑尾炎中疗效的优缺点,总结腹腔镜阑尾切除术的手术经验.方法 连续收集北京大学人民医院自2008年6月至2009年12月129例阑尾炎患者的资料,比较急性阑尾炎患者腹腔镜与开腹手术的临床效果,以及急性与慢性阑尾炎的腹腔镜治疗效果.结果 对于急性阑尾炎患者,接受腹腔镜手术患者术后住院时间明显少于开腹组[(4.8±2.6)d比(7.0±1.3)d,t=0.679,P=0.006].在接受腹腔镜组阑尾切除术的患者中,急性阑尾炎患者的平均手术时间[(77±33) min比(55±23) min,t=3.431,P＜0.01]、术后首次排气时间[(2.3±1.2)d比(1.4±0.9)d,t=4.665,P＜0.01]、术后首次进食时间[(2.3±1.4)d比(1.2±0.6)d,t=4.517,P＜0.01)]均长于慢性阑尾炎患者.结论 腹腔镜阑尾切除术治疗急性阑尾炎安全可行；与慢性阑尾炎患者相比,急性阑尾炎患者行腹腔镜阑尾切除术可能导致更多的术后腹腔脓肿和小肠梗阻等并发症.
目的 通過探討腹腔鏡闌尾切除術在治療急性和慢性闌尾炎中療效的優缺點,總結腹腔鏡闌尾切除術的手術經驗.方法 連續收集北京大學人民醫院自2008年6月至2009年12月129例闌尾炎患者的資料,比較急性闌尾炎患者腹腔鏡與開腹手術的臨床效果,以及急性與慢性闌尾炎的腹腔鏡治療效果.結果 對于急性闌尾炎患者,接受腹腔鏡手術患者術後住院時間明顯少于開腹組[(4.8±2.6)d比(7.0±1.3)d,t=0.679,P=0.006].在接受腹腔鏡組闌尾切除術的患者中,急性闌尾炎患者的平均手術時間[(77±33) min比(55±23) min,t=3.431,P＜0.01]、術後首次排氣時間[(2.3±1.2)d比(1.4±0.9)d,t=4.665,P＜0.01]、術後首次進食時間[(2.3±1.4)d比(1.2±0.6)d,t=4.517,P＜0.01)]均長于慢性闌尾炎患者.結論 腹腔鏡闌尾切除術治療急性闌尾炎安全可行；與慢性闌尾炎患者相比,急性闌尾炎患者行腹腔鏡闌尾切除術可能導緻更多的術後腹腔膿腫和小腸梗阻等併髮癥.
목적 통과탐토복강경란미절제술재치료급성화만성란미염중료효적우결점,총결복강경란미절제술적수술경험.방법 련속수집북경대학인민의원자2008년6월지2009년12월129례란미염환자적자료,비교급성란미염환자복강경여개복수술적림상효과,이급급성여만성란미염적복강경치료효과.결과 대우급성란미염환자,접수복강경수술환자술후주원시간명현소우개복조[(4.8±2.6)d비(7.0±1.3)d,t=0.679,P=0.006].재접수복강경조란미절제술적환자중,급성란미염환자적평균수술시간[(77±33) min비(55±23) min,t=3.431,P＜0.01]、술후수차배기시간[(2.3±1.2)d비(1.4±0.9)d,t=4.665,P＜0.01]、술후수차진식시간[(2.3±1.4)d비(1.2±0.6)d,t=4.517,P＜0.01)]균장우만성란미염환자.결론 복강경란미절제술치료급성란미염안전가행；여만성란미염환자상비,급성란미염환자행복강경란미절제술가능도치경다적술후복강농종화소장경조등병발증.
Objective To explore the clinical outcomes of laparoscopic appendectomy in acute and chronic appendicitis,and sum up the surgical experiences of lapaproscopic appendectomy.Method In this study 129 cases of appendicitis at the Department of Gastroentrological Surgery,Peking University People's Hosptial were collected retrospectively from June 2008 to December 2009.The clinical results of laparoscopic and open procedures for acute appendicitis and the outcomes of laparoscopic operation for acute and chronic appendicitis were compared.Results For acute appendicitis,the length of hospitalization [(4.8 ± 2.6) d vs.(7.0 ± 1.3) d,t =0.679,P =0.006] was significantly shorter in laparoscopic group than that in open surgery group.In addition,the mean length of operation time [(77 ± 33) min vs.(55 ± 23) min,t =3.431,P ＜0.01] were longer,postoperative first passing flatus [(2.3 ± 1.2) d vs.(1.4 ±0.9) d,t =4.665,P ＜0.01] and oral intake [(2.3 ± 1.4) d vs.(1.2 ±0.6) d,t =4.517,P＜0.01] were later for acute appendicitis patients than for chronic appendicitis in laparoscopic group.Conclusions Laparoscopic appendectomy for acute appendicitis is a safe and effective procedure,though it might cause more postoperative complications such as intra-abdominal abscess and small intestinal obstruction in patients with acute appendicitis.
