【摘要】：目的分析經(jīng)臍單孔腹腔鏡術(shù)(UOTLA)治療小兒復(fù)雜性闌尾炎的療效。方法總結(jié)2012年1月-2015年10月在該院治療的78例復(fù)雜性闌尾炎患者臨床資料,其中單孔腹腔鏡手術(shù)的44例患者為UOTLA組,開腹手術(shù)治療的34例患者為開腹闌尾切除術(shù)組(OA),對(duì)兩組患者的手術(shù)時(shí)間、術(shù)后住院時(shí)間、術(shù)后腹腔膿腫、切口感染、早期炎性腸梗阻和疼痛程度等指標(biāo)進(jìn)行統(tǒng)計(jì)分析。結(jié)果化驗(yàn)指標(biāo)中C反應(yīng)蛋白(CRP)在兩組中無明顯差異,外周血白細(xì)胞總數(shù)(WBC)在腹腔鏡組下降較開腹組明顯;手術(shù)相關(guān)指標(biāo)中,UOTLA組手術(shù)時(shí)間較OA組縮短,但差異無統(tǒng)計(jì)學(xué)意義[(66.59±33.24)vs(72.86±30.36)min,P0.05],術(shù)后住院時(shí)間更短[(8.21±1.67)vs(9.21±2.01)d,P0.05]。術(shù)后腹腔膿腫UOTLA組3例,OA組1例(P0.05);切口感染:UOTLA組6例,OA組9例(P0.05);早期炎性腸梗阻:UOTLA組1例,OA組5例(P0.05);疼痛程度比較,UOTLA組較OA組術(shù)后恢復(fù)正�；顒�(dòng)時(shí)間明顯縮短(P0.05),UOTLA組的平均住院費(fèi)用與OA組比較,差異無統(tǒng)計(jì)學(xué)意義[(10 639.37±2 970.92)vs(10 765.04±2 902.64)元,P0.05]。結(jié)論 UOTLA治療小兒復(fù)雜性闌尾炎不但具有創(chuàng)傷小、恢復(fù)快、住院時(shí)間短和美容效果等優(yōu)點(diǎn),而且并沒有明顯增加手術(shù)費(fèi)用,術(shù)后并發(fā)癥也沒有明顯增加,是一種安全有效的手術(shù)方式,可用于治療小兒化膿穿孔性闌尾炎及壞疽穿孔性闌尾炎等相對(duì)復(fù)雜的闌尾炎。
[Abstract]:Objective to evaluate the efficacy of (UOTLA) in the treatment of children with complicated appendicitis. Methods the clinical data of 78 patients with complicated appendicitis treated in our hospital from January 2012 to October 2015 were summarized. Among them, 44 patients were treated by single hole laparoscopic surgery (UOTLA) and 34 by open appendectomy (OA),). The operation time, postoperative hospitalization time, postoperative abdominal abscess, incision infection, early inflammatory intestinal obstruction and pain were analyzed. Results there was no significant difference in C-reactive protein (CRP) between the two groups. The total (WBC) of peripheral blood leukocytes decreased significantly in the laparoscopic group than in the open group. The operative time in UOTLA group was shorter than that in OA group, but there was no significant difference [(66.59 鹵33.24) vs (72.86 鹵30.36) min,P0.05]. The hospital stay was shorter after operation [(8.21 鹵1.67) vs (9.21 鹵2.01) d0. 05]. Postoperative abdominal abscess in UOTLA group (n = 3) and OA group (n = 1); incision infection: UOTLA group (n = 6) and OA group (n = 9); early inflammatory intestinal obstruction: UOTLA group (n = 1) and OA group (n = 5) (P0.05). The pain degree of UOTLA group was significantly shorter than that of OA group (P0.05) the average hospitalization cost of), UOTLA group was significantly shorter than that of OA group [(10 639.37 鹵2 970.92) vs (10 765.04 鹵2 902.64) yuan]. P0.05]. Conclusion the treatment of complicated appendicitis in children with UOTLA not only has the advantages of less trauma, faster recovery, shorter hospital stay and cosmetic effect, but also does not increase the cost of operation and postoperative complications. It is a safe and effective method for the treatment of complicated appendicitis such as suppurative perforated appendicitis and gangrene perforated appendicitis.
【作者單位】： 福建省廈門市婦幼保健院小兒外科;中國醫(yī)科大學(xué)附屬盛京醫(yī)院中心實(shí)驗(yàn)室;
【基金】：2013科技惠民計(jì)劃-科技惠民項(xiàng)目(No:3502Z20134034)
【分類號(hào)】：R726.5

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