阑尾切除术采用微小切口的临床研究

目的　减少阑尾切除手术创伤 ,探索采用微小切口的手术方法和技巧。方法　应用腹腔镜辅助微小切口和直视下小横切口两种方法完成阑尾切除术 6 0例 ,用同期传统麦氏切口阑尾切除术 30例作对照。将手术时间、切口长度、下床时间、进食时间、住院时间、镇痛剂使用和切口感染率进行比较。结果　腹腔镜辅助微小切口阑尾切除术 ,除术后未用镇痛剂及切口无感染外 ,在手术时间、切口长度、下床时间、进食时间、住院时间等方面 ,均较其他两种手术明显缩短 ,差异有显著意义 (P<0 .0 1)。直视下小横切口阑尾切除术 ,较传统麦氏切口阑尾切除术的下床活动、进食时间也有提早(P <0 .0 1)。结论　腹腔镜辅助微小切口阑尾切除术 ,发挥了腹腔镜手术与开腹手术的优点 ,方法简便 ,具有微创意义和推广价值。直视下小横切口阑尾切除术 ,在具有一定经验和掌握手术技巧后应用 ,似较麦氏切口手术优越

The clinical study of appendectomy with laparoscopic micro-incision and small-trans-incision

Objective To explore the techniques of appendectomy with laparoscopic micro-incision and small-trans-incision under direct view. Methods 60 cases of appendectomy were performed by laparoscopic micro-incision and small-trans-incision under direct view, and 30 cases of the appendectomy with McBureney's incision were used as control. The operative time, incision length, bedfast time, fasting time, hospitalized days, application of analygesic and infection rate of incision were compared. Results There were no infection of incision and no analgesic was used in patients undergoing appendectomy with laparoscopic micro-incision. The operative time, incision length, bedfast time, fasting time, hospitalization stay were less than in those undergoing the other two operative procedures (P<0.01). The cases undergoing appendectomy with the small-trans-incision under direct view had a shorter bedfast time and fasting time than those McBurney's incision (P<0.01). Conclusions The appendectomy with the laparoscopic micro-incision has the advantage of laparoscopic and open abdominal operation, and is miniinvasive, simpler and easier. The application of the appendectomy with the small-trans-incision under direct view may be better than appendectomy with McBurney's incision.