摘要
目的探讨经脐切口与脐周切口在腹腔镜阑尾切除术中的应用效果。方法回顾性研究2011—2012年度在我院接受腹腔镜手术的化脓性阑尾炎患者200例,采用随机数字表法将患者分为经脐组和脐周组,每组各100例。经脐组取脐切口,脐周组取脐周切口,均使用传统的腹腔镜阑尾切除术完成手术。观察两组患者手术时间、术中出血量、术后下床时间、住院时间、使用抗生素时间、曲马朵用量、疼痛视觉模拟评分(VAS评分)、患者对伤口满意度及并发症发生情况。结果两组患者手术时间、术中出血量、术后下床时间、住院时间、使用抗生素时间、曲马朵用量、VAS评分比较,差异均无统计学意义(P>0.05)。两组患者对伤口满意度评分比较,差异有统计学意义(P<0.05)。经脐组1例(1%)发生脐部感染,脐周组3例(3%)发生脐部感染,均无伤口疝、血肿形成,两组并发症发生率比较差异无统计学意义(χ2=1.020,P=0.312)。两组均无套管针插入造成器官伤害。结论经脐切口和脐周切口的并发症发生率是无区别,经脐切口是一种安全可行的替代方案,而且更容易操作,并具有更好的美容效果。
Objective To explore the effect of periumbilical and intraumbilical incisions in laparoscopic appendecto-my. Methods A retrospective review was conducted for 200 patients with suppurative appendicitis underwent laparoscopic surgeryin our hospital from 2011 to 2012. The patients were divided into intraumbilical group and periumbilical group randomly with eachgroup 100 cases. Intraumbilical group was treated with the intraumbilical incision, and periumbilical group was treated with theperiumbilical incision,followed by the traditional laparoscopic appendectomy method to complete surgery. The perioperative out-comes were compared according to each laparoscopic incision,including operation time,amount of bleeding,postoperative am-bulation time, postoperative hospital stay, antibiotics usage time, analgesic requirement, pain visual analog scale （VAS）,patients＇ satisfaction at the wound and complications. Results There was no statistically significant difference in operation time, a-mount of bleeding,postoperative ambulation time,postoperative hospital stay,antibiotics usage time,analgesic requirement,and patient pain visual analog scale （VAS） （P 〉 0. 05 ） . The difference was statistically significant between two groups of pa-tients on wound satisfaction score （ P 〈 0. 05 ） . One case in the intraumbilical group （1% ） and 3 cases in the periumbilical group（3% ） developed wound infections, but without no wound hernia or hematoma formation. The umbilical complication rate showedno difference between the two groups （χ^2 = 1. 020, P = 0. 312 ） . No organ damage by trocar insertion was found in the twogroups. Conclusion The wound complication rate of intraumbilical and periumbilical incisions are not significantly different Theintraumbilical incision seems to be a safe and feasible alternative for the periumbilical incision,and it is easier to perform,withbetter cosmetic results.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第18期2093-2095,共3页
Chinese General Practice
基金
2012年广东省医学科研基金(B2012330)
2011年广东省自然科学基金资助项目(S2011010004033)
