摘要
目的对比分析腹腔镜和开腹阑尾切除术在治疗小儿急性阑尾炎中的效果。方法2000年7月-2005年7月，对95例小儿急性阑尾炎实施手术，其中腹腔镜阑尾切除术（laparoscopic appendectomy，LA）50例，开腹阑尾切除术（open appendectomy，OA）45例，比较2组手术情况和疗效。结果2组手术均成功，无出血、肠瘘和残株炎等并发症。LA组手术时间（38．8±17．4）min，OA组（41．9±15．8）min，2组差异无显著性（t=-0．905，P=0．368）。LA组排便时间（26．4±7．2）h，显著短于OA组的（39．7±8．8）h（t=-8．094，P=0．000）。LA组阑尾根部穿孔29例，OA组26例，2组无统计学差异（χ^2=1．633，P=0．983）。OA组切口并发症发生率（11／45）显著高于LA组（2／50）（χ^2=8．381，P=0．004）。OA组放引流管率（9／45）显著高于LA组（3／50）（χ^2=4．206，P=0．040）。LA组体温恢复正常时间（55．4±16．2）h显著短于OA组的（77．8±30．6）h（t=-4．522，P=0．000）。LA组住院时间（5．4±1．3）d显著短于OA组的（13．4±6．5）d（t=-8．520，P=0．000）。LA组住院费用（6117．9±836．5）元显著高于OA组的（4528．6±527．1）元（t=10．937，P=0．000）。结论腹腔镜阑尾切除术较开腹手术具有创伤小、恢复快、腹壁瘢痕轻、并发症少和住院时间短等优点，是治疗小儿急性阑尾炎较为理想的方法。
Objective To compare effects between laparoscopic appendectomy （LA） and open appendectomy （OA） for acute appendicitis in children. Methods A total of 95 children with acute appendicitis from July 2000 to July 2005 were given either LA （LA Group, n = 50） or OA （OA Group, n = 45）. The surgical outcomes and curative effects were compared between the two groups. Results The operation was successfully completed in both of the groups. No bleeding, intestinal fistula, or stump appendicitis was seen. There was no difference in the operation time between the LA Group （38.8 ± 17.4 min） and the OA Group （41.9 ± 15.8 min） （t = -0. 905, P = 0. 368）. The time to first defecation was significantly shorter in the LA Group （26.4 ± 7.2 h） than in the OA Group （ 39.7 ± 8.8 h） （ t = - 8. 094, P = 0. 000）. Appendieeal perforation was found in 29 children in the LA Group and 26 children in the OA Group, without significant difference （χ^2 = 1. 633, P = 0. 983 ） , but the incidence of wound infection was significantly higher in the OA Group （11 children） than in the LA Group （2 children） （χ^2 = 8. 381, P =0. 004）. A drainage placement was required in 3 children in the LA Group and 9 children in the OA Group, with significant difference （χ^2 = 4. 206, P = 0. 040）. The LA Group had significantly shorter time to normal temperature （55.4 ± 16.2 h） than the OA Group （77.8 ± 30.6 h） （t = - 4. 522, P = 0. 000）, shorter hospital stay （5.4 ± 1.3 d） than the OA Group （ 13.4 ± 6.5 d） （ t = - 8. 520, P = 0. 000）, but higher hospitalization costs （6 117.9±836.5 yuan） than the OA Group （4 528.6 ±527.1 yuan） （t=10.937, P=0.000）. Conclusions Laparoscopic appendectomy is superior to open surgery for acute appendicitis in children because of its advantages of minimal invasion, little pain, early recovery, good cosmetic appearance, low complication rate, and short hospital stay.
出处
《中国微创外科杂志》
CSCD
2006年第8期593-594,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜
阑尾炎
小儿
Laparoscopy
Appendicitis
Child
