摘要
目的阑尾周围脓肿患者采用脓肿悬吊法腹腔镜阑尾一期切除术手术效果及术后并发症情况探讨。方法分析2017年1月—2019年6月洛阳石化医院收治的阑尾周围脓肿98例患者的临床资料,其中采用开腹手术治疗的49例作为对照组,采用脓肿悬吊法腹腔镜阑尾一期手术治疗的49例作为观察组。比较两组患者手术指标、术后疼痛和并发症发生情况。结果观察组住院时间(8.64±2.35)d、全血白细胞计数(WBC)恢复时间(3.55±0.83)d、首次排气时间(20.63±5.54)h、术中出血量(16.38±10.73)mL、手术时间(42.94±3.46)min,均少于对照组各项指标,比较有统计学意义(P<0.05),观察组无中转开腹手术病例;观察组和对照组患者术后疼痛评分分别为(4.33±2.16)分和(6.78±1.63)分,24h镇痛药物使用率分别为14.28%和30.61%,观察组患者的24h镇痛药物使用率和术后疼痛评分均低于对照组(P<0.05);观察组切口感染2例,盆腔脓肿1例,肠梗阻1例,残端瘘1例,总发生率10.20%,对照组切口感染5例,盆腔脓肿3例,肠梗阻1例,残端瘘3例,总发生率24.48%,观察组并发症发生率低于对照组(P<0.05)。结论与开腹手术相比,给予阑尾周围脓肿患者脓肿悬吊法腹腔镜手术治疗并发症发生率低,恢复快、术后疼痛轻、出血量少、手术时间短,效果明显。
Objective To investigate the effect of laparoscopic one-stage appendectomy with suspension of abscess in patients with periappendiceal abscess.Methods The clinical data of 98 patients with periappendiceal abscess admitted to Luoyang Petrochemical Hospital from January 2017 to June 2019 were retrospectively analyzed.Among them,49 patients were treated with open surgery as the control group,and 49 patients were treated with abscess suspension laparoscopy as the observation group.The surgical indexes,postoperative pain and complications were compared between the two groups.Results The duration of hospitalization in the observation group was(8.64±2.35)d,the WBC recovery time was(3.55±0.83)d,the first exhaust time was(20.63±5.54)h,the intraoperative blood loss was(16.38±10.73)mL,and the operation time was(42.94±3.46)min.Were lower than those of the control group(P<0.05),and there were no cases of conversion to open surgery in the observation group;Postoperative pain scores of observation group and control group were(4.33±2.16)points and(6.78±1.63)points,respectively.The use rate of analgesic drugs at 24 hours was 14.28%and 30.61%,respectively.The use rate of analgesic drugs at 24 hours and postoperative pain scores of observation group were lower than those of control group(P<0.05).In the observation group,there were 2 cases of incision infection,1 case of pelvic abscess,1 case of intestinal obstruction and 1 case of stump fistula,with a total incidence of 10.20%.In the control group,there were 5 cases of incision infection,3 cases of pelvic abscess,1 case of intestinal obstruction and 3 cases of stump fistula,with a total incidence of 24.48%.The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion Compared with open operation,laparoscopic operation of abscess suspension for periappendiceal abscess has lower complication rate,faster recovery,less postoperative pain,less bleeding,shorter operation time and obvious effect.
作者
冯艳洁
秦欢
王振鹏
FENG Yan-jie;QIN Huan;WANG Zhen-peng(The First Department of Surgery,Luoyang Petrochemical Hospital,Luoyang,Henan 471012,China)
出处
《医药论坛杂志》
2021年第20期82-85,共4页
Journal of Medical Forum
关键词
阑尾周围脓肿
脓肿悬吊法腹腔镜手术
开腹手术
疗效
Periappendiceal abscess
Abscess suspension laparoscopic surgery
Open surgery
The curative effect
