摘要
目的分析比较腹腔镜手术和开腹手术治疗急性阑尾炎的临床疗效和安全性差异。方法回顾性分析2013年7月—2016年5月间皖北煤电集团总医院收治的63例急性阑尾炎并手术治疗患者的临床资料,其中行腹腔镜手术(LA)者33例,行开腹手术(OA)者30例,比较2组间手术时间、术中出血量、胃肠功能恢复时间、住院时间、住院费用、镇痛药物使用率、并发症发生情况包括切口感染、腹腔脓肿、腹腔出血、肠梗阻等;比较2组间手术后外周血白细胞、中性粒细胞计数变化,并将对比的结果及2组的临床资料进行分析。结果 LA组胃肠功能恢复时间、住院时间、术中出血量、镇痛药物使用率均低于OA组,差异具有统计学意义(P<0.05);LA组无并发症出现,OA组有6例出现并发症,LA组并发症发生率明显低于OA组,差异具有统计学意义(P<0.05);2组患者手术时间差异无统计学意义(P>0.05);而LA组住院费用高于OA组(P<0.05);术后1 d,OA组白细胞和中性粒细胞水平显著高于LA组,术后3 d复查白细胞、中性粒细胞水平较前有所下降,但OA组白细胞仍高于LA组,差异具有统计学意义(P<0.05)。结论急性阑尾炎行腹腔镜治疗可使患者快速恢复,缩短住院时间,减少并发症,且显著改善全身炎症反应程度,临床疗效及安全性俱佳,值得在临床中推广和应用。
Objective To compare the clinical effect and safety of laparoscopic and open surgery in the treatment of acute appendicitis. Methods The clinical data of 63 cases of acute appendicitis patients treated with laparoscopic surgery （LA） 33 cases and open operation（OA） 30 cases in our hospital between July,2013 and May,2016 were analyzed retrospectively. The operation time,intraoperative blood loss, gastrointestinal function recovery time, hospital stay, hospital expenses, analgesic drug utilization rate, complications （ incision infection, abdominal abscess, abdominal bleeding, intestinal obstruction, etc. ） and the change of peripheral blood leukocyte and neutrophil count after the operation were compared between the two groups. Results The gastrointestinal function recovery time, hospitalization time, intraoperative blood loss, analgesic drug utilization rate and incidence of complication in LA group were lower than those in the OA group, with statistically significant difference （P 〈 0.05 ）. No complication was found in LA group, with a lower incidence of complica- tions as compared with that in LA group （6 cases ） , the difference was statistically significant （P 〈 0.05 ） ;There was no statistical difference in the operation time between two groups（ P 〈 0.05 ） , while the hospitalization cost in LA group was higher than OA group（P 〈0.05 ）. One day after the operation,the white blood cells and neutrophils count in OA group were higher than that of LA group（ P 〈 0.05） ;on D3, review of white blood cells and neutrophils count were declined,but the white blood cells count in OA group was still higher than that in the LA group （P 〈 0.05 ） , The difference was statistically significant（P 〈 0.05）. Conclusion The laparoscopic treatment for acute appendicitis can promote the recovery of patients, shorten hospital stay, reduce the incidence of complications, and significantly improve the level of systemic inflammation, with good clinical efficacy and safety, it is worth of popularizing in clinical application.
出处
《中华全科医学》
2017年第7期1150-1152,1165,共4页
Chinese Journal of General Practice
基金
安徽省立医院安徽省软科学研究计划项目(1607a-020276)
关键词
腹腔镜手术
急性阑尾炎
临床疗效
Laparoscopic surgery
Acute appendicitis
Clinical effect
