免气腹二孔法微型腹腔镜技术在阑尾切除术中的应用

目的比较免气腹二孔法微型腹腔镜阑尾切除术(mini laparoscopic appendectomy,MLA)与开腹阑尾切除术(open appendectomy,OA)的手术效果。方法将2008年10月~2009年7月23例免气腹二孔法微型腹腔镜尾切除术(MLA组)和同期29例开腹阑尾切除术(OA组)的临床资料进行比较,比较2组手术时间、术后疼痛评分(采用视觉模拟评分即VAS方法,分别于术后24、48、72h进行疼痛评分)、术后胃肠功能恢复时间、术后住院时间、住院费用等指标。结果52例阑尾炎手术全部成功,MLA组手术时间(58.3±24.8)min显著短于OA组(84.9±29.1)min(t=-3.491,P=0.001);MLA组术后疼痛评分24h(2.6±0.8)分、48h(1.4±0.6)分、72h(0.7±0.4)分显著小于OA组24h(5.4±1.2)分(t=-9.614,P=0.000)、48h(3.8±1.2)分(t=-8.751,P=0.000)、72h(2.4±1.2)分(t=-6.502,P=0.000);MLA组术后胃肠功能恢复时间(28.1±14.6)h显著短于OA组(41.3±28.1)h(t=-2.042,P=0.046);MLA组术后住院时间(4.6±1.8)d显著短于OA组(6.8±3.2)d(t=-2.945,P=0.005);MLA组住院费用(4040.7±737.2)元显著高于OA组(3419.6±810.4)元(t=2.855,P=0.006)。结论免气腹二孔法MLA具有创伤更小、恢复快、住院时间短等诸多明显的优点,但住院费用仍较传统方法偏高。

Gasless Two-trocar Mini Laparoscopy for the Treatment of Appendectomy

Objective To compare the efficacy of gasless two-trocar mini laparoscopic appendectomies(MLA)by using two trocars with open appendectomy(OA).Methods Form October 2008 to July 2009,the clinical data of 23 cases of gasless LA with two trocars and 29 cases of traditional open appendectomy(OA)were compared.The operation time,VAS scores at 24,48,and 72 hours after the surgery,postoperative recovery of off-bed activities and gastrointestinal function,and postoperative hospital stay and cost were compared between ...