老年阑尾炎患者腹腔镜阑尾切除效果观察

目的探讨老年阑尾炎腹腔镜微创手术治疗的效果。方法 2005年12月至2009年12月我院收治老年阑尾炎203例,其中腹腔镜阑尾切除术（Laparoscopic appendectomy,LA）72例（LA组）,开腹阑尾切除术（Open appendectomy,OA）131例（OA组）,比较两组病例的手术时间、排气时间、镇痛剂使用、住院时间、术后原发合并症的发生及术后并发症情况。结果 LA组较OA组手术时间、排气时间及住院时间明显缩短,术后镇痛剂应用减少,心肺并发症的发生率及切口感染率较OA组低,差异均有统计学意义（P〈0.05）。结论 LA较OA具有创伤小、肠道功能恢复快、并发症发生率低（如切口感染、粪漏）、住院时间短、能降低心肺并发症的发生等优点,治疗老年人阑尾炎有明显优势。

Observation on the effect of laparoscopic appendectomy in elderly patients with appendicitis

Objective To discuss the effect of minimally invasive laparoscopic surgery in elderly patients with appendicitis. Methods 203 elderly patients with appendicitis in our hospital from December 2005 to December 2009 were assigned to Group LA(72 cases by laparoscopic appendectomy)and Group OA(131 cases by open appendectomy).The two groups were compared in operation time,anal exhaust time,use of anodyne,hospital stay,and incidences of postoperative complications. Results Compared with Group OA,the operation time,anal exhaust time and hospital stay in Group LA was significantly shorter(P < 0.05),the use of postoperative analgesics and the incidence of cardiopulmonary complications decreased,and the infection rate of incisional wound decreased.Differences between the two groups were significant(P < 0.05). Conclusions Compared with laparoscopic appendectomy,open appendectomy leads to less trauma,faster recovery of bowel function,low incidence of complications(such as infection of incisional wound,fecal leakage),and shorter hospital stay,and can reduce the incidence of cardiopulmonary complications,which has significant advantages in the treatment of elderly patients with appendicitis.