经脐单孔腹腔镜治疗小儿复杂性阑尾炎的疗效分析

发布时间：2018-12-12 19:43

【摘要】：目的分析经脐单孔腹腔镜术(UOTLA)治疗小儿复杂性阑尾炎的疗效。方法总结2012年1月-2015年10月在该院治疗的78例复杂性阑尾炎患者临床资料,其中单孔腹腔镜手术的44例患者为UOTLA组,开腹手术治疗的34例患者为开腹阑尾切除术组(OA),对两组患者的手术时间、术后住院时间、术后腹腔脓肿、切口感染、早期炎性肠梗阻和疼痛程度等指标进行统计分析。结果化验指标中C反应蛋白(CRP)在两组中无明显差异,外周血白细胞总数(WBC)在腹腔镜组下降较开腹组明显;手术相关指标中,UOTLA组手术时间较OA组缩短,但差异无统计学意义[(66.59±33.24)vs(72.86±30.36)min,P0.05],术后住院时间更短[(8.21±1.67)vs(9.21±2.01)d,P0.05]。术后腹腔脓肿UOTLA组3例,OA组1例(P0.05);切口感染:UOTLA组6例,OA组9例(P0.05);早期炎性肠梗阻:UOTLA组1例,OA组5例(P0.05);疼痛程度比较,UOTLA组较OA组术后恢复正常活动时间明显缩短(P0.05),UOTLA组的平均住院费用与OA组比较,差异无统计学意义[(10 639.37±2 970.92)vs(10 765.04±2 902.64)元,P0.05]。结论 UOTLA治疗小儿复杂性阑尾炎不但具有创伤小、恢复快、住院时间短和美容效果等优点,而且并没有明显增加手术费用,术后并发症也没有明显增加,是一种安全有效的手术方式,可用于治疗小儿化脓穿孔性阑尾炎及坏疽穿孔性阑尾炎等相对复杂的阑尾炎。
[Abstract]:Objective to evaluate the efficacy of (UOTLA) in the treatment of children with complicated appendicitis. Methods the clinical data of 78 patients with complicated appendicitis treated in our hospital from January 2012 to October 2015 were summarized. Among them, 44 patients were treated by single hole laparoscopic surgery (UOTLA) and 34 by open appendectomy (OA),). The operation time, postoperative hospitalization time, postoperative abdominal abscess, incision infection, early inflammatory intestinal obstruction and pain were analyzed. Results there was no significant difference in C-reactive protein (CRP) between the two groups. The total (WBC) of peripheral blood leukocytes decreased significantly in the laparoscopic group than in the open group. The operative time in UOTLA group was shorter than that in OA group, but there was no significant difference [(66.59 卤33.24) vs (72.86 卤30.36) min,P0.05]. The hospital stay was shorter after operation [(8.21 卤1.67) vs (9.21 卤2.01) d0. 05]. Postoperative abdominal abscess in UOTLA group (n = 3) and OA group (n = 1); incision infection: UOTLA group (n = 6) and OA group (n = 9); early inflammatory intestinal obstruction: UOTLA group (n = 1) and OA group (n = 5) (P0.05). The pain degree of UOTLA group was significantly shorter than that of OA group (P0.05) the average hospitalization cost of), UOTLA group was significantly shorter than that of OA group [(10 639.37 卤2 970.92) vs (10 765.04 卤2 902.64) yuan]. P0.05]. Conclusion the treatment of complicated appendicitis in children with UOTLA not only has the advantages of less trauma, faster recovery, shorter hospital stay and cosmetic effect, but also does not increase the cost of operation and postoperative complications. It is a safe and effective method for the treatment of complicated appendicitis such as suppurative perforated appendicitis and gangrene perforated appendicitis.
【作者单位】：福建省厦门市妇幼保健院小儿外科;中国医科大学附属盛京医院中心实验室;
【基金】：2013科技惠民计划-科技惠民项目(No:3502Z20134034)
【分类号】：R726.5

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