目的探讨腹腔镜阑尾切除术手术治疗急性阑尾炎患者临床疗效分析及其安全性.方法纳入的92例急性阑尾炎患者,随机数字表法随机分为观察组(n=46)与对照组(n=46).观察组给以腹腔镜阑尾切除术治疗,对照组以传统开腹阑尾切除术治疗.比较2组术...目的探讨腹腔镜阑尾切除术手术治疗急性阑尾炎患者临床疗效分析及其安全性.方法纳入的92例急性阑尾炎患者,随机数字表法随机分为观察组(n=46)与对照组(n=46).观察组给以腹腔镜阑尾切除术治疗,对照组以传统开腹阑尾切除术治疗.比较2组术中情况、术后情况及术前、术后1 d和3 d WBC水平变化.结果观察组手术时间短于对照组(t=4.049,P<0.05),淋巴结比较差异无统计学意义(t=0.570,P>0.05),出血量少于对照组(t=20.748,P<0.05);观察组下床活动时间快于对照组(t=9.221,P<0.05),进食时间快于对照组(t=8.794,P<0.05),肛门恢复排气时间快于对照组(t=17.423,P<0.05),住院时间短于对照组(t=13.479,P<0.05),并发症发生率低于对照组(t=13.883,P<0.05);观察组术后1 d和3 d WBC水平均低于术前(t分别=7.277、26.911,P<0.05);观察组术后1 d和3 d WBC水平均低于同期对照组(t分别=3.6189、17.827,P<0.05);观察组术后3 d WBC水平低于术后1 d(t=20.732,P<0.05).结论腹腔镜阑尾切除术治疗急性阑尾炎患者临床疗效显著,是一种安全、有效的治疗方法,值得临床进一步研究.展开更多
Acute appendicitis(AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made ba...Acute appendicitis(AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy(LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time. However, this technique may have some advantages for avoiding unnecessary extended resection in patients with an appendiceal mass. Nonoperative management of AA may be tolerated only in children. Postoperative complications increase according to the patient's factors, and temporal avoidance of emergent general anesthesia may be beneficial for high-risk patients. The surgeon's skill and cooperation of the hospital are important for successful LA. Delaying appendectomy for less than 24 h from diagnosis is safe. Additionally, a semi-elective manner(i.e., LA within 24 h after onset of symptoms) may be paradoxically acceptable, according to the factors of the patient, physician, and institution. Prompt LA is mandatory for AA. Fortunately, the Japanese government uses a universal health insurance system, which covers LA.展开更多
文摘目的探讨腹腔镜阑尾切除术手术治疗急性阑尾炎患者临床疗效分析及其安全性.方法纳入的92例急性阑尾炎患者,随机数字表法随机分为观察组(n=46)与对照组(n=46).观察组给以腹腔镜阑尾切除术治疗,对照组以传统开腹阑尾切除术治疗.比较2组术中情况、术后情况及术前、术后1 d和3 d WBC水平变化.结果观察组手术时间短于对照组(t=4.049,P<0.05),淋巴结比较差异无统计学意义(t=0.570,P>0.05),出血量少于对照组(t=20.748,P<0.05);观察组下床活动时间快于对照组(t=9.221,P<0.05),进食时间快于对照组(t=8.794,P<0.05),肛门恢复排气时间快于对照组(t=17.423,P<0.05),住院时间短于对照组(t=13.479,P<0.05),并发症发生率低于对照组(t=13.883,P<0.05);观察组术后1 d和3 d WBC水平均低于术前(t分别=7.277、26.911,P<0.05);观察组术后1 d和3 d WBC水平均低于同期对照组(t分别=3.6189、17.827,P<0.05);观察组术后3 d WBC水平低于术后1 d(t=20.732,P<0.05).结论腹腔镜阑尾切除术治疗急性阑尾炎患者临床疗效显著,是一种安全、有效的治疗方法,值得临床进一步研究.
文摘Acute appendicitis(AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy(LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time. However, this technique may have some advantages for avoiding unnecessary extended resection in patients with an appendiceal mass. Nonoperative management of AA may be tolerated only in children. Postoperative complications increase according to the patient's factors, and temporal avoidance of emergent general anesthesia may be beneficial for high-risk patients. The surgeon's skill and cooperation of the hospital are important for successful LA. Delaying appendectomy for less than 24 h from diagnosis is safe. Additionally, a semi-elective manner(i.e., LA within 24 h after onset of symptoms) may be paradoxically acceptable, according to the factors of the patient, physician, and institution. Prompt LA is mandatory for AA. Fortunately, the Japanese government uses a universal health insurance system, which covers LA.
