穿孔坏疽阑尾炎患者行开腹和腹腔镜下阑尾炎手术治疗的对比研究
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摘要
目的 探讨更适宜的老年穿孔坏疽阑尾炎的手术方式。方法 选取北京康复医院从2015年11月～2017年12月之间收治的老年患者穿孔坏疽阑尾炎,行切除术的患者100例,采取随机数字法分为开腹(49例)和腔镜组(51例),开腹组采用传统阑尾切除术,腔镜组采用腹腔镜下阑尾切除术。对两组患者手术时间以及总出血量进行比较,同时统计两组手术结束后的排气时间以及住院时间、切口感染率、自觉疼痛程度情况。结果 开腹手术所用时间与腔镜组比较明显缩短(P<0.05);术后切口感染发生比例、术后排气时间及住院康复时间与腔镜比较明显增高(P<0.05);两组术中出血量、住院费用、自觉疼痛程度无统计学意义(P>0.05)。结论 对于老年患者穿孔坏疽阑尾切除术腹腔镜手术降低术后切口感染率,术后肛门排气早,住院时间短,而手术难度增加手术时间延长。
Objective To explore a more suitable surgical method for perforated gangrenous appendicitis in the elderly.Methods 100 elderly patients with perforated gangrenous appendicitis treated in Beijing Rehabilitation Hospital from November 2015 to December 2017 were divided into open group(49 cases) and laparoscopic group(51 cases). The open group was treated with traditional appendectomy, and the laparoscopic group was treated with laparoscopic appendectomy. The operation time and total bleeding volume of the two groups were compared, and the exhaust time after operation, hospital stay,incision infection rate and the degree of conscious pain of the two groups were counted.Results The time of laparotomy was significantly shorter than that of laparoscopy group(P<0.05);the incidence of incision infection,exhaust time and hospitalization recovery time were significantly higher than that of laparoscopy group(P<0.05);there was no significant difference in the amount of bleeding, hospitalization expenses and the degree of conscious pain between the two groups(P>0.05).Conclusion Laparoscopic appendectomy for perforated gangrene in elderly patients can reduce the infection rate of incision after operation. Anal exhaust is early after operation, hospitalization time is short, and the difficulty of operation increases the operation time.
Objective To explore a more suitable surgical method for perforated gangrenous appendicitis in the elderly.Methods 100 elderly patients with perforated gangrenous appendicitis treated in Beijing Rehabilitation Hospital from November 2015 to December 2017 were divided into open group(49 cases) and laparoscopic group(51 cases). The open group was treated with traditional appendectomy, and the laparoscopic group was treated with laparoscopic appendectomy. The operation time and total bleeding volume of the two groups were compared, and the exhaust time after operation, hospital stay,incision infection rate and the degree of conscious pain of the two groups were counted.Results The time of laparotomy was significantly shorter than that of laparoscopy group(P<0.05);the incidence of incision infection,exhaust time and hospitalization recovery time were significantly higher than that of laparoscopy group(P<0.05);there was no significant difference in the amount of bleeding, hospitalization expenses and the degree of conscious pain between the two groups(P>0.05).Conclusion Laparoscopic appendectomy for perforated gangrene in elderly patients can reduce the infection rate of incision after operation. Anal exhaust is early after operation, hospitalization time is short, and the difficulty of operation increases the operation time.
引文
[1]Semm K.Endoscopic appendectomy[J].Endoscopy,1983,15(2):59-64.
[2]曾国祥,黄修仿,彭甫圣.自制单孔装置在经脐单孔腹腔镜阑尾切除术中的临床应用[J].中国社区医师,2016,32(29):72-73.
[3]张立平,邢建华,汤代军,等.急性阑尾炎的超声诊断特征与病理对照研究[J].重庆医学,2018,47(2),262-264.
[4]钟春林,刘文,向荣超,等.腹腔镜阑尾切除术4450例分析[J].临床外科杂志,2017,25(6)448-449.
[2]曾国祥,黄修仿,彭甫圣.自制单孔装置在经脐单孔腹腔镜阑尾切除术中的临床应用[J].中国社区医师,2016,32(29):72-73.
[3]张立平,邢建华,汤代军,等.急性阑尾炎的超声诊断特征与病理对照研究[J].重庆医学,2018,47(2),262-264.
[4]钟春林,刘文,向荣超,等.腹腔镜阑尾切除术4450例分析[J].临床外科杂志,2017,25(6)448-449.