临床外科杂志 ›› 2020, Vol. 28 ›› Issue (4): 347-349.doi: 10.3969/j.issn.1005-6483.2020.04.015

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腹腔镜诊治疑似急性阑尾炎的临床价值分析

  

  1. 234000 安徽省宿州市立医院普外科
  • 出版日期:2020-04-20 发布日期:2020-04-20

Clinical value of laparoscopy in the diagnosis and treatment of suspected acute appendicitis

  1. Department of General Surgery,Suzhou Municipal Hospital,Suzhou,Anhui 234000, China
  • Online:2020-04-20 Published:2020-04-20

摘要: 目的 分析腹腔镜诊断及治疗疑似急性阑尾炎(suspected acute appendicitis,SAA)的临床应用价值。 方法 2013年1月~2018年10月收治的SAA病人86例,根据治疗方式不同分为两组,观察组54例,接受腹腔镜探查+腹腔镜阑尾切除术(laparoscopicexploration+laparoscopicappendectomy,LE+LA),对照组32例,接受传统剖腹探查+阑尾切除术(exploratory laparotomy+openappendectomy,EL+OA),比较两组相关临床指标的差异。 结果 观察组与对照组比较,手术时间、术后肠功能恢复时间及住院时间明显缩短,术中出血量少,术后疼痛程度低,术口感染、腹腔残余脓肿及术后肠梗阻的发生率降低,差异有统计学意义(P<0.05);住院总费用相当,差异无统计学意义(P>0.05)。 结论 对于术前不能确诊的SAA病人,采取LE+LA手术方式诊疗效率高、手术创伤小、术后并发症少、恢复快。

关键词: 急性阑尾炎, 阑尾切除术, 腹腔镜探查

Abstract: Objective To investigate the clinical value of laparoscopy technology in the diagnosis and treatment of suspected acute appendicitis. Methods A total of 86 patients admitted to the department of general surgery of our hospital from January 2013 to October 2018 with a diagnosis of suspected acute appendicitis were selected.54 patients undergoing laparoscopic exploration and laparoscopic appendectomy were divided into the observation group,while 32 patients undergoing traditional exploratory laparotomy and open appendectomy were divided into the control group.Comparing and analyzing the difference of clinical indexes between the two groups after different surgical methods. Results Compared with the control group,the observation group had shorter operation time and less surgical bleeding volume.After operation,the observation group not only felt less pain,but also recovered the intestinal function and performed off-bed activities earlier than the control group.Furthermore,the observation group had shorter hospitalization time and lower incidence of postoperative complications including incision infection,abdominal residual abscess and ileus.Their differences were statistically significant(P<0.05).However there was no significant difference in hospitalization cost between two groups(P>0.05). Conclusion With the advantages of higher diagnostic accuracy and therapeutic efficiency,smaller surgical trauma,slighter pain,less postoperative complications,and quicker recovery,the laparoscopy technology is efficient in the diagnosis and treatment of suspected acute appendicitis.

Key words: acute appendicitis, appendectomy, laparoscopic exploration

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