腹腔镜一期手术治疗阑尾周围脓肿临床探讨

摘要
图/表
参考文献(18)
相关文章 (15)

全文: PDF (0 KB) HTML (38 KB)
输出: BibTeX | EndNote (RIS)

摘要目的研究腹腔镜一期手术治疗阑尾周围脓肿的临床效果和可行性。方法选择2012年10月～2015年10月我院收治的118例急性阑尾周围脓肿患者，根据术式的不同分为A组（48例）、B组（38例）、C组（32例）。A组行腹腔镜手术，B组行开腹手术，C组采用保守治疗，分析三组的手术时间、住院时间、住院费用、并发症发生率等。结果 A组中，38例进行一期腹腔镜阑尾切除术，10例进行脓肿引流术，无中转开腹。B组中，20例行一期阑尾切除术，18例行脓肿引流术。A组的手术持续时间短于B组，切口长度长于B组，差异有统计学意义（P＜0.01）。A组与B组的引流量、术中出血量比较，差异无统计学意义（P＞0.05）。A组的体温和白细胞恢复正常时间、术后下床时间、肛门排气时间、引流时间、使用抗生素时间、住院时间短于B组，并发症发生率低于B组，差异有统计学意义（P＜0.01）。A组与B组的住院费用比较，差异无统计学意义（P＞0.05）。A组的体温和白细胞恢复至正常时间、住院时间短于C组，并发症发生率低于C组，差异有统计学意义（P＜0.05）。B组的体温和白细胞恢复正常时间短于C组，并发症发生率高于C组，差异有统计学意义（P＜0.05）。B组与C组的住院费用、住院时间比较，差异无统计学意义（P＞0.05）。结论腹腔镜一期手术治疗阑尾周围脓肿具有可行性和安全性，优于开腹手术及保守治疗，损伤小、恢复快、切口不易感染，能够明显缩短阑尾周围脓肿的病程。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	常春
	李锋
	池宇明

关键词 ：腹腔镜, 阑尾周围脓肿, 开腹手术, 保守治疗

Abstract：

ObjectiveTo study the clinical efficacy and feasibility of a one stage laparoscopic surgery in the treatment of periappendiceal abscess.MethodsFrom October 2012 to October 2015,118 cases of acute periappendiceal abscess in our hospital were selected and divided into group A(48 cases),group B(38 cases)and group C(32 cases)according to the different methods of operation.Group A was treated with laparoscopic surgery,group B was treated with open surgery,and group C was treated with conservative treatment.The operation time,hospitalization time,hospitalization expenses,the incidence rate of complications of the three groups were analyzed.ResultsIn group A,38 patients underwent one stage laparoscopic surgery,and 10 patients underwent abscess drainage without conversion to laparotomy.In group B,20 cases underwent one stage appendectomy,and 18 cases received abscess drainage.The duration of operation in group A was shorter than that in group B,and the length of incision in group A was longer than that in group B,with significant difference (P＜0.01).There was no significant difference between group A and group B in the amount of drainage and the amount of bleeding during operation (P＞0.05).The body temperature and the time of normal recovery of leukocyte,the time of getting out of bed,the time of anal exhaust,the time of drainage,the time of using antibiotics and the length of hospitalization in group A was shorter than that of group B,and the incidence rate of complication in group A was lower than that of group B,with significant difference(P＜0.01).There was no significant difference between group A and group B in the hospitalization expenses (P＞0.05).The body temperature and the time of normal recovery of leukocyte,hospitalization time in group A were shorter than that in group C,and the incidence rate of complication in group A was lower than that in group C,with significant difference (P＜0.05).The body temperature and the time of normal recovery of leukocyte in group B was shorter than that in group C,and the incidence rate of complication in group B was higher than that in group C,with significant difference (P＜0.05).There was no significant difference between group B and group C in the hospitalization expenses and the hospitalization time (P＞0.05).ConclusionOne stage laparoscopic surgery in the treatment of periappendiceal abscess is feasible and safe,which is better than open surgery and conservative treatment,less damage,quick recovery,less infection,and can shorten the course of periappendiceal ab-scess.

Key words： Laparoscope Periappendiceal abscess Laparotomy Conservative treatment

作者简介: 常春（1972-），男，医学硕士，副主任医师，主要从事胃肠道疾病的微创手术研究

引用本文:

常春;李锋;池宇明. 腹腔镜一期手术治疗阑尾周围脓肿临床探讨[J]. 中国当代医药, 2017, 24(23): 30-33.
CHANG Chun;LI Feng;CHI Yu-ming. Clinical study exploration of a one stage laparoscopic surgery in the treatment of periappendiceal abscess. 中国当代医药, 2017, 24(23): 30-33.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I23/30

[1]	徐维华，汪立鑫，赵兰，等.大黄、芒硝外敷辅助治疗阑尾周围脓肿 95 例[J].山东医药，2011，51（22）：77-78.
[2]	Meshikhes A.Appendiceal mass：is interval appendicectomy“something of the past”？[J].World J Gastroenterol，2011，17（25）：2977-2980.
[3]	王存川，陈均，许朋，等.经腹腔镜治疗阑尾周围脓肿10例分析[J].暨南大学学报（医学版），2001，22（4）：125-126.
[4]	Towfi S，Chen F，Masson R，et al.Lapamscopic appendectomy reduces length of stay for perforated appendicitis[J].Surg Endosc，2006，20（3）：495-499.
[5]	王轲，金先庆，李晓庆，等.318例小儿阑尾脓肿的临床治疗分析[J].重庆医学，2010，39（17）：2323-2324.
[6]	黄奕，江龚兵，侯金华，等.腹腔镜结合小切口手术处理急性复杂性穿孔性阑尾炎[J].中国微创外科杂志，2011，11（8）：754-755.
[7]	Vettoretto N，Agresta F.A brief review of laparoscopic appendectomy：the issues and the evidence[J].Tech Coloproctol，2011，15（1）：1-6.
[8]	阮剑，龚昭，胡思安，等.腹腔镜治疗阑尾周围脓肿的应用探讨[J].中国内镜杂志，2007，13（7）：773-774.
[9]	冯宇名.分析腹腔镜治疗阑尾周围脓肿临床治疗[J].中国实用医药，2008，3（10）：105-106.
[10]	王玉祥，李应红，许兴，等.困难性阑尾炎腹腔镜下治疗体会[J].中国微创外科杂志，2010，10（7）：664-666.
[11]	徐振辕，齐生伟，殷克卿.腹腔镜治疗阑尾周围脓肿的疗效分析[J].白求恩军医学院学报，2009，7（2）：86-87.
[12]	Lim SG，Ahn EJ，Kim SY，et al.A clinical comparison of laparoscopic versus open appendectomy for complicated appendicitis[J].Korean Soc Coloproctol，2011，27（6）：293-297.
[13]	陈志忠，梁子明.手术治疗75例阑尾周围脓肿[J].中国医药科学，2011，1（12）：155.
[14]	易石坚，王兴群，赵振伟.腹腔镜一期阑尾切除治疗阑尾周围脓肿的临床研究[J].中国普通外科杂志，2010，19（9）：1051-1052.
[15]	黄奕江，龚兵，侯金华，等.腹腔镜结合小切口手术处理急性复杂性穿孔阑尾炎[J].中国微创外科杂志，2011，11（8）：754-755.
[16]	Shindholimath VV，Thinakaran K，Rao TN，et al.Laparoscopic management of appendicular mass[J].Minim Access Surg，2011，7（2）：136-140.
[17]	Hong KD，Lee BJ，Lee Y，et al.Periappendiceal abscessmimicking appendiceal cancer[J].Surg Laparose Endosc Percutan Tech，2012，22（1）：31-33.
[18]	Muensterer OJ，Puga Nougues C，Adibe OO，et al.Appendectomy using single-incision pediatric endosurgery for acuteand perforated appendicitis[J].Surg Endosc，2010，24（12）：3201-3204.