小切口手術與傳統手術治療急性闌尾炎療效比較

[摘要] 目的 探討小切口手術與傳統手術治療急性闌尾炎臨床療效。 方法 選擇我院2009年2月～2012年12月就診的120例急性闌尾炎患者，根據治療方法分為兩組，每組60例，觀察組進行小切口闌尾切除術治療，對照組進行傳統闌尾切除術治療，觀察兩組患者術中出血量、平均手術時間、住院時間、術后排氣時間及并發癥情況，并進行比較分析。 結果 觀察組手術時間、術中出血量及術后排氣時間、術后住院時間，觀察組明顯均優于對照組，差異具有統計學意義（P<0.05）。觀察組術后出現感染3例（5%）、腹腔膿腫3例（5%），并發癥總發生率為10%，并發癥總發生率均明顯低于對照組26.7%（P<0.05）。 結論 小切口手術具有創傷小、出血量小、術后康復快、并發癥少的優點，療效顯著，在急性闌尾炎患者治療中值得廣泛應用。

[關鍵詞] 急性闌尾炎；小切口闌尾切除術；超聲定位

[中圖分類號] R656 [文獻標識碼] B [文章編號] 2095-0616（2013）13-199-02

Comparison of efficacy of small incision appendectomy and traditional operation in treatment of acute appendicitis

XIONG Hongdian

Department of the Third General Surgery， Zhumadian Central Hospital， Zhumadian 463000， China

[Abstract] Objective To study the clinical effect of small incision appendectomy and traditional operation in treatment of acute appendicitis. Methods The clinical data of 120 patients with acute appendicitis who were in hospital from February 2009 to December 2011 were retrospectively analyzed. All patients were divided into the control group and the experiment group according to the treatment method， with 60 cases in each group. The experiment group was given small incision appendectomy and the control group was treated by traditional operation. The amount of bleeding， the average operation time， hospitalization time， postoperative exhaust time and complications of two groups were observed and compared. Results In experiment group， the average operation time were shorter，the bleeding volumes were less and the postoperative evacuating time of the experiment group was earlier than those of the control group. The differences were statistically significant （P<0.05）. The observation group postoperative infection in 3 cases （5%）， 3 cases of abdominal abscess （5%）， the overall complication rate was 10%. The overall complication rate of observation group was significantly lower than the control group 26.7% （P<0.05）. Conclusion Small incision appendectomy has the advantages of little trauma， little bleeding， faster postoperative recovery， less complications. It has obvious curative effect， it is widely used in the treatment of patients with acute appendicitis.

[Key words] Acute appendicitis； Small incision appendectomy； Ultrasound localization

急性闌尾炎是外科常見病，也是最多見的急腹癥，是由闌尾官腔阻塞、細菌入侵、胃腸道疾病等因素引起的炎性病變，主要表現為轉移性右下腹痛以及闌尾點的壓痛和反跳痛，歐美國家每年平均發病率約0.1%[1]。早期診斷、早期治療，患者多可在短期逆恢復健康，降低死亡率，原則上急性闌尾炎一經確診，應盡早行手術治療[2]。麥氏切口行闌尾切除術是傳統手術方法，沿用至今，，隨著醫學技術的發展，已不能滿足患者對生活質量需求。小切口手術越來越受到臨床醫生的重視。本研究回顧性分析我院2009年2月～2012年12月就診的120例急性闌尾炎患者臨床資料，旨在探討小切口手術與傳統手術治療急性闌尾炎臨床療效，現報道如下。……