腹腔镜下阑尾切除术与传统开腹阑尾切除术的临床疗效比较

目的比较腹腔镜阑尾切除术（laparoscopic appendectomy，LA）和开腹阑尾切除术（open appendectomy，OA）的临床疗效。方法将2006年5月至2010年7月收治的206例行阑尾切除术的急性阑尾炎病人按手术方法分为LA组（98例）和OA组（108例）．比较两种术式的手术时间、术中出血量，肛门排气时间、术后下床活动时间、术后切口感染率、术后使用止痛药情况，术后抗生素使用时间、腹腔残余感染率、住院时间和住院费用。结果LA组在手术时间、术后肛门排气时间、下床活动时间、切口感染率、腹腔残余感染率、住院时间、术后抗生素使用时间、止痛药使用情况与OA组比较差异有显著性（P〈0．05）。术中出血量及住院费用与OA组比较无显著差异（P〉0．05）。结论腹腔镜下阑尾切除术具有手术创伤小，术后恢复快，切口感染率低，住院时间短等优势。不足的是与传统开放手术相比较，费用偏高。

Clinical Analysis of Laparoscopic Appendectomy and Open Appendectomy for Acute Appendicitis

Objective To compare the clinical effect of laparoscopic appendectomy（LA） vs open appendectomy（OA） for acute appendicitis. Methods A retrospective analysis was performed for 206 patients undegoing appendectomy from May 2006 to July 2010, who were divided into LA group（98 cases） and OA group（108 cases）. The variables were analyzed, which included operating time, anal exhaust time, postoperative incision infection rate, abdominal residual infection rate, the length of hospital stay, postoperative painkillers, postoperative antibiotic use time, hospitalization costs and the amount of bleeding in operation. Results There was significant difference in operating time, anal exhaust time, postoperative incision infection rate, abdominal residual infection rate, the length of hospital stay, postoperative painkillers and postoperative antibiotic use time （P 〈0.05）. There was no significant difference in hospitalization costs and the amount of bleeding in operation （P 〉0.05）. Conclusions Laparoscopic appendectomy has the advantages such as small surgical trauma, rapid postoperative recovery, low incision infection rate, short hospitalization time, however, compared to the traditional open operation, its disadvantage is high cost.