摘要
目的对比腹腔镜治疗小儿复杂性阑尾炎有无合并脓肿的安全性和有效性。方法回顾性分析2017年5月至2023年9月期间福建医科大学附属漳州市医院收治的363例复杂性阑尾炎患儿临床资料,将其划分为无合并脓肿组(277例)与阑尾周围脓肿组(86例),比较两组手术情况及术后并发症发生率。结果阑尾周围脓肿组比无合并脓肿组病史时间长[5(3~7)d比2(1~3)d,Z=-11.59,P<0.05]、手术时间长[86(68~121)min比63(50~76)min,Z=-7.260,P<0.05]、术中出血量多[5(3~10)ml比2(2~5)ml,Z=-7.010,P<0.001],差异均有统计学意义。阑尾周围脓肿组术后并发症发生率高,术后腹腔脓肿发生率(11.1%比6.9%,χ^(2)=1.656,P=0.198)、切口感染发生率[4.9%比4.0%,χ^(2)=0.008,P=0.930]、肠梗阻发生率(4.9%比3.2%,χ^(2)=0.158,P=0.691)、肠管损伤率(1.3%比0,P=0.226)差异均无统计学意义。结论腹腔镜治疗小儿阑尾周围脓肿是安全、有效的,尤其对于病史时间<7 d的阑尾周围脓肿患儿。
Objective To explore the safety and effectiveness of laparoscopic treatment for complicated appendicitis in children with and without abscess.Methods A retrospective analysis was conducted on the clinical data of 363 patients with complicated appendicitis admitted to our department between May 2017 and Sep 2023.Patients were divided into two groups:the group without abscess and the group with abscess,comparing the surgical outcomes and incidence of postoperative complications between two groups.Results As a result,all 277 cases in the non abscess group completed laparoscopic appendectomy,while all 86 cases in the periappendibular abscess group also completed laparoscopic appendectomy.The history of appendiceal abscess group was longer than that of the group without abscess[5(3-7)d vs.2(1-3)d,Z=-11.59,P<0.05],the operation time was longer[86(68-121)min vs.63(50-76)min,Z=-7.260,P<0.05],intraoperative bleeding was more[5(3-10)ml vs.2(2-5)ml,Z=-7.010,P<0.001].The incidence of postoperative complications was higher in the appendiceal abscess group,with a postoperative abdominal abscess rate of 11.1%,compared to 6.9%(χ^(2)=1.656,P=0.198),and the incision infection rate of 4.9%,compared to 4.0%(χ^(2)=0.008,P=0.930),the intestinal obstruction rate was 4.9%,compared to 3.2%,(χ^(2)=0.158,P=0.691),the intestinal injury rate was 1.3%,compared to 0,(P=0.226).Conclusions Laparoscopic appendectomy for periappendiceal abscess in children was safe and effective,especially for patients with a medical history of less than 7 d.
作者
王炳杰
刘敏超
李政
许笃行
陈文有
蔡丽生
Wang Bingjie;Liu Minchao;Li Zheng;Xu Duxing;Chen Wenyou;Cai Lisheng(Department of General Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China;Department of Hepatobiliary and Hernia Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China;Department of Pediatric Surgery,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China;Department of Gastrointestinal and Soft Tissue Sarcoma,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China)
出处
《中华普通外科杂志》
北大核心
2025年第9期714-719,共6页
Chinese Journal of General Surgery
基金
福建医科大学启航基金项目资助(2020QH1293)。
关键词
阑尾炎
腹部脓肿
阑尾切除术
腹腔镜
Appendicitis
Abdominal abscess
Appendectomy
Laparoscopy
