腹腔镜阑尾切除术阑尾残端荷包缝合包埋与Hem-o-lok的比较

目的探讨荷包缝合包埋阑尾残端在腹腔镜阑尾切除术中的应用价值。方法2010年6月-2013年6月因急慢性阑尾炎行腹腔镜阑尾切除术101例，采用2种不同方法处理阑尾残端：50例阑尾根部行丝线结扎后，荷包缝合包埋残端（包埋组）；5l例用Hem-o-lok夹闭阑尾根部后，不再进一步处理阑尾残端（Hem-o-lok组），比较2组手术时间和术后患者恢复情况。结果2组术后并发症、术后住院时间无显著性差异（P〉0．05）。包埋组手术时间（55．8±5．8）min，明显长于Hem-o-lok组（44．8±5．7）min（t=9．613，P=0．000）；包埋组手术费用（5086±58）元，显著少于Hem-o-lok组（5430±50）元（t=-31．945，P=0．000）。结论2种处理阑尾残端的方法都是安全、有效的，但荷包缝合包埋阑尾残端更符合传统阑尾切除术的手术操作要求，对术者腹腔镜操作水平要求较高，但节省手术费用。Hem-o-lok夹闭阑尾根部节省手术时间，操作简单，更适合于初学者。

A Comparison of Purse-string Suture and Hem-o-lok Ligation in Securing of the Base of the Appendix in Laparoscopic Appendectomy

Objective To compare purse-string suture and Hem-o-lok ligation in securing of the base of the appendix in laparoscopic appendectomy. Methods From June 2010 to June 2013, there were 101 patients undergoing laparoseopic appendectomy in our hospital. They were treated by two different methods in securing of the base of the appendix： silk ligation of the stump and purse-string suture embedment was performed in 50 cases （ embedment group） ; while stump ligation by using Hem-o-lok clips was performed in 51 cases （Hem-o-lok group）. Two groups were compared in operation time and post-operative patient recovery. Results Between the both groups, postoperative eomp｜ications and postoperative hospital stay had no significant differences （P 〉 0.05）. The operation time of the embedment group （55.8 ± 5.8 ） min was significantly longer than that of the Hem-o-lok group （44.8 ±5.7） rain （t = 9. 613, P = 0. 000）. The hospitalization expenditure of the embedment group （5086 ± 58） yuan was significantly less than that of the Hem-o-lok group （5430 ± 50） yuan （t = - 31. 945, P = 0. 000）. Conclusions Both methods are safe and effective in securing of the base of the appendix in laparoseopic appendectomy. Purse-string suture embedment is more in line with traditional appendectomy requirements and cost effective, but requiring more skilled laparoscopie manipulation. Hem-o-lok clipping of the appendix saves operation time and is easy to perform, which is more suitable for beginners.