CAJ | 학술논문

目的：探讨在基层医院应用腹腔镜对急、慢性阑尾炎患者行阑尾切除术的临床应用价值及应用注意事项。方法选取本院2008年1月～2013年12月所完成的腹腔镜阑尾切除术126例，从中转开腹数、手术时间、出血量、住院时间等多个方面分析其应用价值，以及在基层医院的应用注意事项。结果腹腔镜阑尾切除术126例，中转开腹6例，中转开腹率4.76%，中转开腹原因主要有阑尾根部及盲肠壁水肿明显，组织较脆（4/6），阑尾根部坏疽（2/6）。结论腹腔镜阑尾切除术在治疗慢性阑尾炎及急性单纯性阑尾炎和早期化脓性阑尾炎的患者中效果显著。但阑尾炎症波及盲肠壁致阑尾根部及盲肠壁水肿明显、组织较脆时及急性炎症性粘连严重以及阑尾根部坏疽时仍限制了其应用，仍不能完全代替传统开腹手术。
목적：탐토재기층의원응용복강경대급、만성란미염환자행란미절제술적림상응용개치급응용주의사항。방법선취본원2008년1월～2013년12월소완성적복강경란미절제술126례，종중전개복수、수술시간、출혈량、주원시간등다개방면분석기응용개치，이급재기층의원적응용주의사항。결과복강경란미절제술126례，중전개복6례，중전개복솔4.76%，중전개복원인주요유란미근부급맹장벽수종명현，조직교취（4/6），란미근부배저（2/6）。결론복강경란미절제술재치료만성란미염급급성단순성란미염화조기화농성란미염적환자중효과현저。단란미염증파급맹장벽치란미근부급맹장벽수종명현、조직교취시급급성염증성점련엄중이급란미근부배저시잉한제료기응용，잉불능완전대체전통개복수술。
Objective To discuss clinical application value and application notes of laparoscopic appendectomy in patients with acute and chronic appendicitis in basic level hospitals.MethodsSelected 126 cases of laparoscopic appendectomy from January 2008 to December 2013 in our hospital, the application value and application notes in basic level hospitals are analyzed from the aspects of conversion to open surgery, operation time, bleeding amount, length of hospitalstay.Results126 cases of laparoscopic appendectomy, 6 cases of the conversion to laparotomy, the rate of conversion to laparotomy was 4.76% the reasons of conversion to laparotomy including the root of appendix and lamina edema, tissue fragility (4/6), root gangrenous appendix (2/6).Conclusion The effect that laparoscopic appendectomy treats patients with chronic appendicitis , acute appendicitis and early suppurative appendicitis is remarkable. But when the appendicitis affects the caecum wall, there will be the root of the appendix and caecum wall edema, tissue fragility, serious eonglutination and gangrene at root of appendix.So laparoscopic appendectomy is limited to use ,it can not completely replace the traditional open surgery.