[1]蔡宝,徐冰,胡耀宗,等.腹腔镜手术与开腹手术治疗小儿穿孔性阑尾炎的疗效比较[J].临床小儿外科杂志,2018,17(03):223-225.
　Cai Bao,Xu Bing,Hu Yaozong,et al.Comparative study on the postoperative recovery effect of Laparoscopic versus open appendectomy in the perforated appendicitis in children.[J].Journal of Clinical Pediatric Surgery,2018,17(03):223-225.
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腹腔镜手术与开腹手术治疗小儿穿孔性阑尾炎的疗效比较

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年03期 页码: 223-225 栏目: 论著 出版日期: 2018-03-28
Title:
Comparative study on the postoperative recovery effect of Laparoscopic versus open appendectomy in the perforated appendicitis in children.
作者:
蔡宝; 徐冰; 胡耀宗; 等
安徽医科大学附属安庆医院小儿外科
Author(s):
Cai Bao; Xu Bing; Hu Yaozong; Zhang Faming; Huang Shan; Tian Jia; Wu Fan; Bao Shiming.
Department of Pediatric Surgery,Anqing Hospital Affiliated to Anhui Medical University,Anqing 246003,China.
关键词:
腹腔镜;  剖腹术;  阑尾炎;  治疗结果;  对比研究;  儿童
Keywords:
Laparoscopes;  Laparotomy;  Appendicitis;  Treatment Outcome;  Comparative Study;  Child
文献标志码:
A
摘要:
目的　比较腹腔镜与开腹手术治疗小儿穿孔性阑尾炎的临床疗效。　方法　收集本院
２０１３ 年１０ 月至２０１６ 年９ 月确诊为穿孔性阑尾炎患儿１４８ 例，其中６８ 例采用腹腔镜（ ＬＡ 组）手术治疗，
８０ 例采用开腹（ ＯＡ 组）手术治疗，对比分析两组患儿术后疗效及并发症情况。　结果　术后下床活动
时间：ＬＡ 组较ＯＡ 组短（１８． ２ ±２． ４ ｈ ｖｓ ２５． ５ ±４． ７ ｈ） ，差异有统计学意义（ ｔ ＝４． １５，Ｐ ＜０． ００１） ；术后排
气时间：ＬＡ 组较ＯＡ 组短（３２． ６ ±８． ４ ｈ ｖｓ ５３． ０ ±６． ５ ｈ） ，差异有统计学意义（ ｔ ＝ ５． ７５，Ｐ ＜ ０． ００１） ；住院
时间：ＬＡ 组较ＯＡ 组短（７． ０ ±１． ４ ｄ ｖｓ ９． ３ ±２． ３ ｄ） ，差异有统计学意义（ ｔ ＝２． ４９，Ｐ ＝ ０． ０２３） ；术后切口
感染发生率：ＬＡ 组１ 例（１． ５％ ） ，ＯＡ 组１５ 例（１８． ８％ ） ，差异有统计学意义（ ｘ２ ＝ １１． ３８，Ｐ ＜ ０． ００１） ；残
余感染发生率：ＬＡ 组０ 例，ＯＡ 组７ 例（８． ８％ ） ，差异有统计学意义（ ｘ２ ＝ ６． ２５，Ｐ ＜ ０． ００１） ；肠梗阻发生
率：ＬＡ 组１ 例（１． ５％ ） ，ＯＡ 组８ 例（１０％ ） ，差异有统计学意义（ ｘ２ ＝４． ６８，Ｐ ＝ ０． ０１８） 。　结论　腹腔镜
阑尾切除术治疗小儿穿孔性阑尾炎的临床效果明显优于开腹阑尾切除术，术后恢复快，住院时间短，并
且可以明显降低术后并发症的发生率，是治疗小儿急性穿孔性阑尾炎的理想术式。
Abstract:
ObjectiveTo compare the postoperative recovery effect of laparoscopic and open appendectomy in children with perforated appendicitis.MethodsA retrospective analysis was conducted on 148 cases with perforated appendicitis in Anqing Hospital Affiliated to Anhui Medical University from October 2013 to September 2016.In the cohort,68 cases were treatment with laparoscopic procedure (LA group) and 80 cases were treatment by open appendectomy (OA group).The complications and therapeutic effects were compared between the two groups.ResultsPostoperative exercise time was significantly shorter in the LA group than in the OA group (18.2 h±2.4 h vs 25.5 h±4.7 h,t=4.15,P<0.001).The time required for postoperative restoration of anal exhaust was significantly shorter in the LA group than in the OA group (32.6 h±8.4 h vs 53.0 h±6.5 h,t=5.75,P<0.001).Hospitalization time in the LA group was significantly shorter than that in the OA group (7.0 d±1.4 d vs 9.3 d±2.3 d,t=2.49,P<0.05).Wound infection occurred in 1 child in the LA group and in 15 children in the OA group (P<0.001).Postoperative abdominal residual infection occurred in 7 children in the OA group and no infection in the LA group.(χ2=11.38,P<0.001).Bowel obstruction occurred in 1 child in the LA group and in 8 children in the OA group (χ2=4.68,P<0.05).ConclusionLA has many advantages over OA in the treatment of perforated appendicitis in children,such as early recovery,short hospital stay,and low complication rate.Therefore,LA is a satisfactory method in the treatment of perforated appendicitis in children.

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