腹腔镜与开腹手术治疗急性化脓性阑尾炎及坏疽性阑尾炎的临床疗效对比
|
摘要
目的对比腹腔镜与开腹手术治疗急性化脓性阑尾炎及坏疽性阑尾炎的临床疗效。方法回顾性分析2014年5月至2018年5月首都医科大学附属北京朝阳医院收治的224例急性化脓性及坏疽性阑尾炎患者的临床资料,根据治疗方法分为腔镜组119例和开腹组105例,腔镜组做腹腔镜阑尾切除术,开腹组做开腹阑尾切除术,比较两组手术的临床疗效。结果两组患者术前体温、白细胞、谷丙转氨酶、谷草转氨酶、纤维蛋白原及高血压、糖尿病、冠心病、腹腔既往手术史等,差异无显著性(P>0.05)。两组术中腹腔引流管放置比例相比,差异无显著性(P>0. 05),手术时间、出血量、切口长度、首次排气时间、下床时间、尿管拔除时间、住院时间、住院费用等相比,差异有显著性(P<0. 05);两组切口感染率相比,差异有显著性(P<0. 05)。粘连性肠梗阻、腹腔脓肿、泌尿系感染发生率等差异均无显著性(P>0. 05)。结论腹腔镜手术治疗急性化脓性及坏疽性阑尾炎具有手术时间短,出血量少,康复快、切口感染率低等优点。
引文
[1]冯方栋.腹腔镜与小切口手术治疗合并2型糖尿病的老年急性较比阑尾炎疗效比较[J].中国医刊,2018,53(12):1349-1351.
[2] Wei B, Qi CL, Chen TF, et al. Laparoscopic versus open appendectomy for acute appendicitis:a meta analysis[J]. Sury Endosc,2011,25(4):1199-1208.
[3] Tzovaras G,Baloyiannis I,Kouritas V.et al. Laparoscopic versus open appendectomy in men:a prospective randomized trial[J]. Surg Endosc,2010,24(12):2987-2992.
[4] McGrath B, Buckius MT,Grim R,et al. Economics of appendicitis:cost trend analysis of laparoscopic versus open appendectomy from1998 to 2008[J].J Surg Res,2011(171):el61-el68.
[5] Sauerland S.Lefering R,Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis(review)[J]. Cochrane Database Syst Rev,2010(10):CD001546.
[6] Krisher SL.Browne A.Dibbins A.et al. Intra-abdominal abscess after laparoscopic appendectomy for perforted appendicitis[J]. Arch Surg,2001(136):438-441.
[7] Jaffer L, Cameron AE. Laparoscopic appendectomy:a junior trainee's learning curve[J]. JSLS,2008(12):288-291.
[8] Nakhamiayev V,Galldin L.Chiarello M,et al. Laparoscopic appendectomy is preferred approach for appendicitis:a retrospective review of review of two practice pattern[J]. Surg Endose,2010(24):859-864.
[9]牟东成.腹腔镜技术在急性右下腹痛诊断和治疗中的临床价值[J].中国临床医生杂志,2018,46(3):316-318.
[10] Markides G, Subar D,Riyad K. Laparoscopic versus open appendectomy in adults with complicated appendicitis:systematic review and meta-analysis[J]. W orld J Surg,2010(34):2026-2040.
[11] Ohtani H,tamamori Y, ArimotoY,et al. Metaanalysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis[J].J Gastrointest Surg,2012(16):1929-1939.
[12] Massoomi H, Mills S,Dolich MO,et al. Comparison of outcomes of laparoscopic versus open appendectomy in adults:date from the nationwide inpatient sample(NIS), 2006-2008[J]. J Gastronest Surg,2011(15):2226-2231.
[13] Xiao Y,Shi G,Zhang J,et al. Surgical site infection after laparoscopic and open appendectomy:a multicenter large consecutive cohort study[J].Surg Endosc, 2014(29):1384-1393.
[14] Wei B,Qi CL, Chen TF,et al. Laparoscopic verus open appendectomy for acute appendicitis:a meta analysis[J]. Surg Endosc,2011,25(4):1199-1208.
[15] W ilson DG, Bond AK, Ladwa N, et al. Intra-abdominal collections versus open appendicectomy:an experience of 516 consecutive cases at a district at a district general hospital[J]. Surg Endocs,2013(27):2351-2356.
[16] Swank HA, Eshuis EJ, Van Berge Henegouwen, et al. Short-and longterm results of open versus laparoscopic appendectomy[J]. W orld J Surg,2011(35):1221-1226.
[17] Li X,Ghang J,Sang L,et al. Laparoscopic versus conventional-a meta-analvsis of randomized controlled trial[J].BMC Gastroenterol,2010(10):129.
[2] Wei B, Qi CL, Chen TF, et al. Laparoscopic versus open appendectomy for acute appendicitis:a meta analysis[J]. Sury Endosc,2011,25(4):1199-1208.
[3] Tzovaras G,Baloyiannis I,Kouritas V.et al. Laparoscopic versus open appendectomy in men:a prospective randomized trial[J]. Surg Endosc,2010,24(12):2987-2992.
[4] McGrath B, Buckius MT,Grim R,et al. Economics of appendicitis:cost trend analysis of laparoscopic versus open appendectomy from1998 to 2008[J].J Surg Res,2011(171):el61-el68.
[5] Sauerland S.Lefering R,Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis(review)[J]. Cochrane Database Syst Rev,2010(10):CD001546.
[6] Krisher SL.Browne A.Dibbins A.et al. Intra-abdominal abscess after laparoscopic appendectomy for perforted appendicitis[J]. Arch Surg,2001(136):438-441.
[7] Jaffer L, Cameron AE. Laparoscopic appendectomy:a junior trainee's learning curve[J]. JSLS,2008(12):288-291.
[8] Nakhamiayev V,Galldin L.Chiarello M,et al. Laparoscopic appendectomy is preferred approach for appendicitis:a retrospective review of review of two practice pattern[J]. Surg Endose,2010(24):859-864.
[9]牟东成.腹腔镜技术在急性右下腹痛诊断和治疗中的临床价值[J].中国临床医生杂志,2018,46(3):316-318.
[10] Markides G, Subar D,Riyad K. Laparoscopic versus open appendectomy in adults with complicated appendicitis:systematic review and meta-analysis[J]. W orld J Surg,2010(34):2026-2040.
[11] Ohtani H,tamamori Y, ArimotoY,et al. Metaanalysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis[J].J Gastrointest Surg,2012(16):1929-1939.
[12] Massoomi H, Mills S,Dolich MO,et al. Comparison of outcomes of laparoscopic versus open appendectomy in adults:date from the nationwide inpatient sample(NIS), 2006-2008[J]. J Gastronest Surg,2011(15):2226-2231.
[13] Xiao Y,Shi G,Zhang J,et al. Surgical site infection after laparoscopic and open appendectomy:a multicenter large consecutive cohort study[J].Surg Endosc, 2014(29):1384-1393.
[14] Wei B,Qi CL, Chen TF,et al. Laparoscopic verus open appendectomy for acute appendicitis:a meta analysis[J]. Surg Endosc,2011,25(4):1199-1208.
[15] W ilson DG, Bond AK, Ladwa N, et al. Intra-abdominal collections versus open appendicectomy:an experience of 516 consecutive cases at a district at a district general hospital[J]. Surg Endocs,2013(27):2351-2356.
[16] Swank HA, Eshuis EJ, Van Berge Henegouwen, et al. Short-and longterm results of open versus laparoscopic appendectomy[J]. W orld J Surg,2011(35):1221-1226.
[17] Li X,Ghang J,Sang L,et al. Laparoscopic versus conventional-a meta-analvsis of randomized controlled trial[J].BMC Gastroenterol,2010(10):129.