1368例腹腔镜阑尾切除术手术方式选择的临床研究

目的研究腹腔镜阑尾切除术选择改良三孔法、三孔法及二孔法手术方式的优缺点。方法选取玉林市第二人民医院自2008年1月至2013年1月收治的需行腹腔镜阑尾切除术患者1368例,按照随机数字表法分成改良组(460例)、三孔组(458例)和二孔组(450例),改良组采取改良三孔法腹腔镜阑尾切除术治疗,三孔组采取三孔法腹腔镜阑尾切除术治疗,二孔组采取二孔法腹腔镜阑尾切除术治疗,比较三组手术时间、住院时间、术后肛门排气时间、肠蠕动恢复时间。结果改良组、三孔组和二孔组手术时间、住院时间、术后肛门排气时间、肠蠕动恢复时间的比较,差异无统计学意义(P>0.05)。改良组并发症发生率16.74%,三孔组并发症发生率19.00%,二孔组并发症发生率21.11%,三组并发症发生率比较差异无统计学意义(P>0.05)。结论腹腔镜阑尾切除术中改良三孔法、三孔法及二孔法各有利弊,应视患者具体情况进行选择,但其中三孔法仍是最成熟的一种手术方式。

Clinical Research of Laparoscopic Appendectomy Surgical Manner Selection in 1368 Cases

Objective To study the advantages and disadvantages of improved three-hole laparoscopic appendectomy, three-hole and two holes method for laparoscopic appendectomy. Methods A total of 1368 cases needing laparoscopic appendectomy from Yulin City Second ＇People＇s Hospital during Jan. 2008 and Jan. 2013 were selected, and randomly divided into improved three-hole group （460 cases）, three-hole group （458 cases） and two-hole group （ 450 cases） by random-number table method, the operative time, hospital stay, postoperative flatus,bowel recovery time of the three groups were compared. Results The operative time, hospital stay, postoperative flatus, bowel recovery time of the three groups had no statistically significant difference（ P 〉0.05 ）. The complication rate of the improved three-hole group was 16.74%, of three-hole group was 19.00% ,of two-hole group was 21.11%, and the difference was not statistically significant （P 〉 0.05 ）. Conclusion The improved three-hole, three-hole and two-hole approaches for laparoscopic appen dectomy have advantages and disadvantages respectively, thus should be selected depending on the specific circumstances of the patient, though three-hole approach is still the most matured type of surgery.