腹腔镜和开腹手术治疗化脓性阑尾炎的对比研究

目的探讨腹腔镜阑尾切除术治疗化脓性阑尾炎的临床应用价值。方法回顾分析113例化脓性阑尾炎的手术治疗病例,其中行腹腔镜阑尾切除术61例（LA组）,行开腹阑尾切除术52例（OA组）。比较两组的手术时间、术中出血量、术后肛门排气时间、术后疼痛程度、术后住院时间、切口感染率和住院费用。结果 LA组中有4例中转开腹。LA组的住院费用和术中出血量高于OA组（P〈0.05）,术后疼痛程度和切口感染率较OA组低（P〈0.05）。两组患者在手术时间、术后住院时间和术后肛门排气时间的差异无统计学意义（P〉0.05）。结论腹腔镜和开腹手术治疗化脓性阑尾炎各有优势,临床工作中应根据患者具体病情和医师的手术经验合理选用。

Comparative study of laparoscopic appendectomy and open appendectomy for suppurative appendicitis

Objective To investigate the therapeutic effect of laparoscopic appendectomy（LA） and open appendectomy（OA） for suppurative appendicitis.Methods The clinical data of 113 patients with suppurative appendicitis underwent surgeries between March 2011 and December 2012 were analyzed.Among them,61 cases were treated by LA and 52 cases were treated by OA.The operation time,blood loss,time of anal exhaust,pain,postoperative hospital stay,complications and hospitalization cost between the two groups were compared.Results There were 4 cases converting to open surgery in LA group.The cost and blood loss in LA group were higher than those in OA group（P0.05）.There was no statistical significance in the operation time,postoperative hospital stay and time of anal exhaust between two groups（P0.05）.The pain and incision infection rate in LA group were lower than those in OA group（P0.05）.Conclusion There are respective advantages in using LA and OA for suppurative appendicitis.The clinical application should be based on the patient＇s condition and experiences of the surgeon.