陈玉 韩戟 杨力

【摘要】 目的 观察并对比腹腔镜和开腹阑尾切除术在治疗穿孔性阑尾炎中的手术效果。

方法 72例穿孔性阑尾炎患者作为研究对象， 随机分为对照组与观察组， 每组36例。对照组实施开腹阑尾切除术进行治疗， 观察组实施腹腔镜阑尾切除术进行治疗。对比分析两组的手术效果。结果 观察组手术时间、下床时间、肛门排气时间、住院时间均短于对照组， 差异均具有统计学意义（P<0.05）。观察组并发症发生率2.78%低于对照组的19.44%， 差异具有统计学意义（P<0.05）。结论 在穿孔性阑尾炎的治疗中， 腹腔镜阑尾切除术手术效果优于开腹阑尾切除术， 具有广泛的应用价值， 值得推广。

【关键词】 腹腔镜；开腹；阑尾切除术；穿孔性阑尾炎

DOI：10.14163/j.cnki.11-5547/r.2018.10.004

【Abstract】 Objective To observe and compare the surgical effect of laparoscopic and open appendectomy in the treatment of perforated appendicitis. Methods A total of 72 patients with perforated appendicitis as study subjects were randomly divided into control group and observation group， with 36 cases in each group. The control group was treated with open appendectomy， and the observation group was treated with laparoscopic appendectomy. The surgical effect in two groups was compared and analyzed. Results The observation group had shorter operation time， off-bed time， anal exhaust time and hospitalization time than the control group， and the difference was statistically significant （P<0.05）. The observation group had lower incidence of complications as 2.78% than 19.44% in the control group， and the difference was statistically significant （P<0.05）. Conclusion During the treatment of perforated appendicitis， laparoscopic appendectomy shows better surgical effect than open appendectomy， and it contains wide application value and is worthy of promotion.

【Key words】 Laparoscope； Open； Appendectomy； Perforated appendicitis

阑尾炎主要是指阑尾遭受多种因素的影响而发生的炎性改变， 当病情发展严重后就会发生穿孔， 临床表现主要有恶心呕吐、持续伴阵发性加剧的右下腹痛、发热等， 有很大可能会引发败血症、肠梗阻等严重并发症， 严重威胁患者的生命安全[1]。对于穿孔性阑尾炎的治疗一般以手术方式为主， 主要有传统阑尾切除术、腹腔镜阑尾切除术。传统阑尾切除术有着非常成熟的技术条件， 但是对患者造成的创伤比较大， 且术后并发症发生率较高；腹腔镜阑尾切除术属于微创手术， 有着创伤小、并发症少等特点[2， 3]。为了观察并对比腹腔镜和开腹阑尾切除术在治疗穿孔性阑尾炎中的手术效果， 作者通过选取穿孔性阑尾炎患者72例进行分组研究， 两组分别实施开腹阑尾切除术以及腹腔镜阑尾切除术两种治疗模式， 并对这两种方法在治疗穿孔性阑尾炎中的手术效果实施对比， 现报告如下。……