SPLA与CLA术治疗急性阑尾炎的临床对比研究
|
摘要
目的探讨SPLA术与CLA治疗急性阑尾炎的临床疗效。方法回顾性收集我科130例急性阑尾炎患者临床资料为研究对象,患者均予以腹腔镜下手术,根据术式分为单孔组(经脐单孔,SPLA组)与三孔组(传统腹腔镜三孔,CLA组),比较两组手术时间、术中出血量,并比较术后体温正常时间、术后排气时间、术后住院日及疼痛,并比较两组阑尾的病例类型。结果单孔组手术时间(92.3±21.8)min,显著长于三孔组(52.7±14.2)min(P<0.05),但两组术中出血量并无显著差异(P>0.05);单孔组体温恢复正常时间(67.8±17.4)h,VAS评分(3.7±0.7)分均显著短于三孔组(75.7±14.8)min、(4.1±0.9)分(P<0.05),但两组的术后排气时间、住院时间、阑尾病理类型比较无统计学意义(P>0.05);单孔组温哥华瘢痕量表评分(3.05±0.72)分,显著低于三孔组(3.34±0.81)分(P<0.05),但两组的厚度、血管分布并无显著差异(P>0.05)。结论经脐单孔与传统腹腔镜三孔均能有效治疗急性阑尾炎,手术适应症相似,但前者创伤更小,且符合外观审美。
Objective To explore the clinical efficacy of SPLA and CLA in the treatment of acute appendicitis. Methods The clinical data of 130 patients with acute appendicitis in our department were retrospectively collected as study subjects.All patients were given laparoscopic surgery, and they were divided into single-port group(transumbilical single-port laparoscopic appendectomy, SPLA group) and three-port group(conventional three-port laparoscopic appendectomy,CLA group) according to the surgical methods. The operative time and intraoperative blood loss were compared between the two groups, and the postoperative normal temperature time, postoperative exhaust time, postoperative hospital stay and pain were compared, and the appendix pathological types were compared between the two groups.Results The operative time in single-port group was significantly longer than that in three-port group [(92.3±21.8) min vs(52.7±14.2) min](P<0.05), but there was no significant difference in the intraoperative blood loss between the two groups(P>0.05). The normal recovery time of body temperature and VAS score in single-port group were significantly shorter than those in three-port group [(67.8±17.4) h vs(75.7±14.8) min,(3.7±0.7) points vs(4.1±0.9) points](P<0.05),but there were no significant differences between the two groups in postoperative exhaust time, hospital stay and appendix pathological types(P>0.05). The Vancouver scar scale score in single-port group was significantly lower than that in three-port group [(3.05±0.72) points vs(3.34±0.81) points](P<0.05), but there were no significant differences in thickness and blood vessel distribution between the two groups(P>0.05). Conclusion Transumbilical single-port laparoscopic appendectomy and conventional three-port laparoscopic appendectomy both can effectively treat acute appendicitis, and they have similar surgical indications, but the former one has smaller trauma and is aesthetically pleasing.
Objective To explore the clinical efficacy of SPLA and CLA in the treatment of acute appendicitis. Methods The clinical data of 130 patients with acute appendicitis in our department were retrospectively collected as study subjects.All patients were given laparoscopic surgery, and they were divided into single-port group(transumbilical single-port laparoscopic appendectomy, SPLA group) and three-port group(conventional three-port laparoscopic appendectomy,CLA group) according to the surgical methods. The operative time and intraoperative blood loss were compared between the two groups, and the postoperative normal temperature time, postoperative exhaust time, postoperative hospital stay and pain were compared, and the appendix pathological types were compared between the two groups.Results The operative time in single-port group was significantly longer than that in three-port group [(92.3±21.8) min vs(52.7±14.2) min](P<0.05), but there was no significant difference in the intraoperative blood loss between the two groups(P>0.05). The normal recovery time of body temperature and VAS score in single-port group were significantly shorter than those in three-port group [(67.8±17.4) h vs(75.7±14.8) min,(3.7±0.7) points vs(4.1±0.9) points](P<0.05),but there were no significant differences between the two groups in postoperative exhaust time, hospital stay and appendix pathological types(P>0.05). The Vancouver scar scale score in single-port group was significantly lower than that in three-port group [(3.05±0.72) points vs(3.34±0.81) points](P<0.05), but there were no significant differences in thickness and blood vessel distribution between the two groups(P>0.05). Conclusion Transumbilical single-port laparoscopic appendectomy and conventional three-port laparoscopic appendectomy both can effectively treat acute appendicitis, and they have similar surgical indications, but the former one has smaller trauma and is aesthetically pleasing.
引文
[1]厉英超,米琛,李伟之,等.内镜下逆行阑尾炎治疗术对急性阑尾炎的诊治价值[J].中华消化内镜杂志,2016,33(11):759-763.
[2]许东,徐红艳,于浩,等.经脐单孔与传统三孔腹腔镜阑尾切除术的比较[J].中国微创外科杂志,2016,16(9):787-789.
[3]卞剑,未德成,戚士芹.单孔腹腔镜结合阑尾悬吊治疗小儿急性阑尾炎[J].安徽医药,2016,20(6):1116-1118.
[4]王军,曹斌校,李绍刚,等.腹腔镜对急性阑尾炎腹内感染患儿炎症因子水平和免疫功能的临床影响研究[J].中华医院感染学杂志,2016,26(22):5213-5215.
[5]Gregory S,Kuntz K,et al.Cost-Effectiveness of Integrating a Clinical Decision Rule and Staged Imaging Protocol for Diagnosis of Appendicitis[J].Value in Health,2016,19(1):28-35.
[6]徐宁,王元杰,刘贵远,等.经脐自制单孔腔镜与三孔腹镜阑尾切除手术的比较[J].徐州医学院学报,2017,37(5):319-321.
[7]张甜.经脐单孔腹腔镜治疗小儿急性阑尾炎临床效果评价[J].中国中西医结合儿科学,2016,8(1):70-72.
[8]何苗,范晶,王子卫,等.成人单孔法与传统法腹腔镜阑尾切除术临床疗效比较的Meta分析[J].医学综述,2016,22(23):4714-4717.
[9]沈刚,王月凤,李功俊,等.单孔腹腔镜与多孔腹腔镜手术治疗小儿阑尾炎的对比分析[J].中国医师进修杂志,2017,40(7):627-629.
[10]尹克宁,卓凡.单孔腹腔镜手术治疗急性阑尾炎的临床疗效[J].腹腔镜外科杂志,2018,23(2):109-112.
[11]王德仲,康春博,李文强,等.经脐单孔腹腔镜阑尾切除术中阑尾系膜不同处理方法的临床研究[J].医学综述,2017,23(15):3114-3117.
[12]刘兴军,吴硕东,陈永生.经脐单切口与传统三孔腹腔镜阑尾切除术的回顾性对比研究[J].中国微创外科杂志,2016,16(9):784-786.
[2]许东,徐红艳,于浩,等.经脐单孔与传统三孔腹腔镜阑尾切除术的比较[J].中国微创外科杂志,2016,16(9):787-789.
[3]卞剑,未德成,戚士芹.单孔腹腔镜结合阑尾悬吊治疗小儿急性阑尾炎[J].安徽医药,2016,20(6):1116-1118.
[4]王军,曹斌校,李绍刚,等.腹腔镜对急性阑尾炎腹内感染患儿炎症因子水平和免疫功能的临床影响研究[J].中华医院感染学杂志,2016,26(22):5213-5215.
[5]Gregory S,Kuntz K,et al.Cost-Effectiveness of Integrating a Clinical Decision Rule and Staged Imaging Protocol for Diagnosis of Appendicitis[J].Value in Health,2016,19(1):28-35.
[6]徐宁,王元杰,刘贵远,等.经脐自制单孔腔镜与三孔腹镜阑尾切除手术的比较[J].徐州医学院学报,2017,37(5):319-321.
[7]张甜.经脐单孔腹腔镜治疗小儿急性阑尾炎临床效果评价[J].中国中西医结合儿科学,2016,8(1):70-72.
[8]何苗,范晶,王子卫,等.成人单孔法与传统法腹腔镜阑尾切除术临床疗效比较的Meta分析[J].医学综述,2016,22(23):4714-4717.
[9]沈刚,王月凤,李功俊,等.单孔腹腔镜与多孔腹腔镜手术治疗小儿阑尾炎的对比分析[J].中国医师进修杂志,2017,40(7):627-629.
[10]尹克宁,卓凡.单孔腹腔镜手术治疗急性阑尾炎的临床疗效[J].腹腔镜外科杂志,2018,23(2):109-112.
[11]王德仲,康春博,李文强,等.经脐单孔腹腔镜阑尾切除术中阑尾系膜不同处理方法的临床研究[J].医学综述,2017,23(15):3114-3117.
[12]刘兴军,吴硕东,陈永生.经脐单切口与传统三孔腹腔镜阑尾切除术的回顾性对比研究[J].中国微创外科杂志,2016,16(9):784-786.