腹腔镜手术治疗阑尾周围脓肿临床分析

目的 探讨腹腔镜治疗阑尾周围脓肿的疗效和优势.方法 94例阑尾周围脓肿患者完全随机分为腹腔镜组(34例)、开腹手术组(27例)和保守治疗组(33例),分别采用腹腔镜手术、开腹手术及药物治疗.对3组的治疗情况、住院时间、并发症发生情况等进行对比分析.结果 腹腔镜组平均手术时间(49.7±3.7)min,拔管时间(3.2±0.9)d,肠鸣音恢复时间(22.2±2.4)h;开腹手术组平均手术时间(60.9±4.5)mim,拔管时间(4.7±1.1)d,肠鸣音恢复时间(30.4±1.6)h.3项指标差异均有统计学意义(P<0.01或P<0.05).腹腔镜组34例中28例行一期腹腔镜阑尾切除术加引流,6例行脓肿引流,无中转开腹,无残余脓肿或切口感染.开腹手术组27例21例行一期阑尾切除,6例行脓肿清除引流术,并发切口感染5例,残余脓肿1例,1例复发再行阑尾切除术.保守治疗组33例均在住院期间症状缓解,7例出院后复发再回院行手术治疗.3组均未出现肠梗阻或死亡病例.结论 腹腔镜手术治疗阑尾周围脓肿优于开腹手术及保守治疗,明显缩短病程.

Abstract：

Objective To investigate the curative effect and advantage of therapeutic laparoscopy of periappendiceal abscess. Methods Totally 94 cases with periappendiceal abscess were randomly assigned into laparo-scopic group(LO,n =34) , conventional laparotomy group (CO, n =27) and expectant treatment group (EX, n = 33). The treatment effectiveness of three groups, including operative time, restoration process, length of stay and complications was observed. Results Twenty eight cases of the LO group had one-stage laparoscopic appendectomy. The other six cases were performed abscess drainage. 21 cases of the CO group had one-stage laparoscopic appendectomy. The other 6 cases were performed abscess drainage. Five of them got an infection of incisional wound and the other one case had retained abscess. Thirty three cases of EX group had the symptoms relieved and were discharged, but seven of them recurred and underwent surgeries. No intestinal obstruction or death occurred in these groups. Conclusion Therapeutic laparoscopy of periappendiceal abscess is safe and effective of treating periappendiceal abscess.

Clinical analysis of therapeutic laparoscopy of periappendiceal abscess

Objective To investigate the curative effect and advantage of therapeutic laparoscopy of periappendiceal abscess. Methods Totally 94 cases with periappendiceal abscess were randomly assigned into laparo-scopic group(LO,n =34) , conventional laparotomy group (CO, n =27) and expectant treatment group (EX, n = 33). The treatment effectiveness of three groups, including operative time, restoration process, length of stay and complications was observed. Results Twenty eight cases of the LO group had one-stage laparoscopic appendectomy. The other six cases were performed abscess drainage. 21 cases of the CO group had one-stage laparoscopic appendectomy. The other 6 cases were performed abscess drainage. Five of them got an infection of incisional wound and the other one case had retained abscess. Thirty three cases of EX group had the symptoms relieved and were discharged, but seven of them recurred and underwent surgeries. No intestinal obstruction or death occurred in these groups. Conclusion Therapeutic laparoscopy of periappendiceal abscess is safe and effective of treating periappendiceal abscess.