摘要
目的对比分析腹腔镜阑尾切除术(laparoscopic appendectomy,LA)和开腹阑尾切除术(open appendectomy,OA)治疗肥胖儿童阑尾炎的疗效。方法回顾性分析商丘市第一人民医院2015年6月至2019年6月收治的365例肥胖患儿的临床资料,比较LA组(187例)和OA组(178例)手术时间、术中出血量、术后排气时间、术后止痛药使用次数、住院天数、住院费用及术后并发症的发生率。结果LA组手术时间、术中出血量、术后排气时间、术后止痛药使用次数、住院天数均低于OA组(均P<0.05),住院费用高于OA组(P<0.05);术后并发症总发生率两组差异无统计学意义(9.1%比14.6%,P>0.05),但LA组切口感染率低于OA组(2.7%比7.9%,P<0.05),腹腔脓肿发生率高于OA组(3.2%比1.1%,P<0.05),肠梗阻、出血、输尿管损伤发生率比较无统计学意义(均P>0.05),两组均无阑尾残株炎并发症;LA组有4例中转开腹。结论LA与OA相比具有手术时间短,创伤小,恢复快,术后切口感染率低等优点,是治疗肥胖患儿较好手术方式,值得临床推广和发展,但应注意术后腹腔脓肿发生率和住院费较高。
Objective To compare laparoscopic appendectomy(LA)with open appendectomy(OA)in the treatment of appendicitis in obese children.Methods This study included 365 consecutively admitted patients with acute appendicitis undergoing laparoscopic(187 cases)or open(178 cases)appendectomy.Clinical outcomes were compared between the 2 groups in relation to operative time,intraoperative bleeding volume,intestinal recovery period,the rate of using acesodyne,length of hospital stay,in hospital cost and postoperative complications.Results All the variables in LA group were better than those in OA group except the hospital cost and postoperative complications,the differences were statistically significant(all P<0.05).LA group higher in hospital cost(P<0.05);There was no statistically significant difference in postoperative complications(9.1%vs.14.6%,P>0.05).But lower incidence of wound infection(2.7%VS.7.9%,P<0.03),higher intra-abdominal abscess formation was significantly after laparoscopic surger(3.2%VS.1.1%,P<0.05).the others were no statistical significance.In LA group,4 cases were converted to open surgery.Condusions LA is a better operative for acute appendicitis in obese children with short hospital stay,tiny operational trauma,early recovery and lower incidence of wound infection except for higher incidence of intra-abdominal abscess and hospital cost.it was worthy of clinical promotion and development.
作者
刘成远
李俊江
穆速
王坤
韩祥松
崔广宾
LIU Cheng-yuan;LI Jun-jiang;MU Su;WANG Kun;HAN Xiang-song;CUI Guang-bin(Department of Gastrointestinal Hepatobiliary,the First People’s Hospital of Shangqiu,Shangqiu,Henan 476100,China)
出处
《医药论坛杂志》
2021年第15期69-72,共4页
Journal of Medical Forum
