摘要
目的对比分析肥胖患者行腹腔镜与开腹阑尾切除术的临床效果。方法回顾性分析2008--2010年因急性阑尾炎在中国医科大学附属盛京医院行阑尾切除术的肥胖患者153例的临床资料。153例中，腹腔镜阑尾切除术92例（其中4例转为开腹），开腹阑尾切除术61例，对两种术式的手术时间、术中出血量、术后排气时间、术后止痛药使用频率、术后主要并发症的发生率、住院时间和住院费用进行比较。计数资料比较采用χ2检验，计量资料采用￡检验。结果腹腔镜阑尾切除术组在手术时间、术中出血量、术后排气时问、术后止痛药使用频率、术后主要并发症的发生率、住院时间方面均短于或少于开腹阑尾切除术组，差异有统计学意义（手术时间：t=14．0，P〈0．01；术中出血量：t=19．7，P〈0．0l；术后排气时间：t=12．3，P〈0．01；术后止痛药使用频率：t=21．01，P〈0．01；术后主要并发症的发生率：χ2=40．138，P〈0．01；住院时间：t=17．3，P〈0．01）。两者在住院总花费上的差异无统计学意义（t=1．434，P=0．154）。结论肥胖患者行腹腔镜阑尾切除术治疗阑尾炎与开腹阑尾切除术相比具有创伤小、恢复快、并发症少和平均住院时间短等优点，是治疗肥胖阑尾炎患者理想的手术方式。
Objective To evaluate laparoscopic appendectomy（LA） and open appendectomy（OA） in obese patients. Methods From January 2008 to November 2010, 153 obese patients with appendicitis were operated on, 92 cases were treated with initial LA and 61 cases with upfront OA. The operative time, intraoperative bleeding volume, intestinal recovery period, the rate of using acesodyne, major postoperative complications, the duration and hospital cost were studied. Results In LA group, 4 cases were converted to open surgery. All the variables in LA group were better than those in OA group except the hospital cost and the differences were statistically significant （ the operative time ： t = 14.0, P 〈 0. 001 ; intraoperative bleeding volume ： t = 19. 7, P 〈 0. 001 ; intestinal recovery period ： t = 12. 3, P 〈 0. 001 ; the rate of using acesodyne：t = 21.01, P 〈 0. 001 ; main postoperative complications ： χ2 = 40. 138, P 〈 0. 001 ; the hospital stay ： t = 17. 3, P 〈 0. 001 ） except the in-hospital cost （ t = 1. 434, P 〉 0. 05 ）. Conclusions Compared with OA, LA is a better choice for obese patients with appendicitis because of its advantages of minimal injury, early recovery, less complications and short hospital stay.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第6期491-494,共4页
Chinese Journal of General Surgery
