CAJ | 학술논문

目的：分析穿孔性阑尾炎治疗中使用腹腔镜手术的应用价值。方法将我院2011年1月至2013年11月收治的180例穿孔性阑尾炎患者，根据患者的意愿分成对照组和观察组，两组各90例。对照组患者采用传统开腹手术进行阑尾切除治疗，观察组患者采用腹腔镜下阑尾切除手术治疗。比较两组的手术疗效、不良反应、并发症以及治疗费用。结果观察组手术时间、下床活动时间、肛门排气时间、止痛药使用率、切口感染率、残余脓肿发生率以及住院时间均显著低于对照组，差异具有统计学意义(P＜0.05)；但在综合治疗费用方面，观察组显著高于对照组，差异具有统计学意义(P＜0.05)。结论尽管使用腹腔镜手术治疗穿孔性阑尾炎费用较高，但其手术中出血量低、术后并发症发生率低、术后排气时间短以及住院时间短的优势，可以对手术费用进行有效弥补，其应用价值高，可以作为穿孔性阑尾炎治疗的首选方式，值得临床推广。
목적：분석천공성란미염치료중사용복강경수술적응용개치。방법장아원2011년1월지2013년11월수치적180례천공성란미염환자，근거환자적의원분성대조조화관찰조，량조각90례。대조조환자채용전통개복수술진행란미절제치료，관찰조환자채용복강경하란미절제수술치료。비교량조적수술료효、불량반응、병발증이급치료비용。결과관찰조수술시간、하상활동시간、항문배기시간、지통약사용솔、절구감염솔、잔여농종발생솔이급주원시간균현저저우대조조，차이구유통계학의의(P＜0.05)；단재종합치료비용방면，관찰조현저고우대조조，차이구유통계학의의(P＜0.05)。결론진관사용복강경수술치료천공성란미염비용교고，단기수술중출혈량저、술후병발증발생솔저、술후배기시간단이급주원시간단적우세，가이대수술비용진행유효미보，기응용개치고，가이작위천공성란미염치료적수선방식，치득림상추엄。
Objective To analyze the value of laparoscopic surgery in the treatment of perforated appendicitis. Methods 180 cases of patients with perforated appendicitis admitted to our hospital from January 2011 and November 2013 were divided into control group and observation group according to patients' motivation, with 90 cases in each group. The control group was given traditional laparotomy for appendix resection, and the observation group was given appendectomy under the laparoscopy. The clinical effects, adverse reactions, complications and treatment costs were compared between the two groups. Results The operation time, leaving bed time, anus exhausting time, usage rate of anodynes, rate of incision infection, incidence of residual abscess and hospitalization time in the observation group were significantly lower than those of the control group, with statistically significant difference (P<0.05). But the treatment cost of the observation group was significantly higher than that of the control group, with statistically significant difference (P<0.05). Conclusions Despite the high cost of laparoscopic surgery, the advantages of low complications, low bleeding volume, short exhausting time and short hospitalization time can effectively make up for the high cost. Laparoscopic surgery has high application value and can be serve as the preferred way to treat perforated appendicitis, which deserves promotion in clinic.