微创医学

目的探讨免气腹二孔法微型腹腔镜阑尾切除术(miniature laparoscopic appendectomy,MLA)的效果。方法将82例阑尾炎患者随机分成两组,一组行免气腹二孔法微型腹腔镜阑尾切除术(MLA组,n=41),另一组行传统开腹阑尾切除术(open appendectomy,0A组,n=41),比较两组右下腹切口长度、手术时间、术后疼痛评分、术前术后CRP、术前术后IL-6、术后下床活动时间、术后胃肠功能恢复时间、术后住院时间、住院费用等指标。结果 82例阑尾炎手术全部成功,MLA组右下腹切口长度明显短于OA组(P=0.000);MLA组手术时间与OA组(P=0.070)相近;MLA组术后24 h、48 h、72 h疼痛评分指数显著小于OA组(P=0.000);MLA组术前CRP、IL-6与OA组(P=0.935)相近,MLA组术后24 h及72 h CRP、IL-6均小于OA组(P=0.000);MLA组术后下床活动时间、术后胃肠功能恢复时间、术后住院时间显著短于OA组(P=0.000);MLA组与OA组并发症发生率相近(P=0.331);MLA组切口美观指数明显小于... 更多

Objective To explore the effect of gasless two-port miniature laparoscopic appendectomies ( MLA) ． Method 82 cases of appendicitis patients were randomly divided into two groups: one was underwent gasless two-port miniature laparoscopic appendectomy( MLA group，n = 41) ， another was performed with tradition open appendectomy ( OA group，n = 41) ． Right lower abdominal incision length，operation time， postoperative pain score，the preoperative and postoperative CRP and IL-6，postoperative out-of-bed activity time，gastrointestinal function recovery time，postoperative hospital stay，hospitalization expenses and other indicators of two groups were compared． Result All 82 cases of appendicitis operation were successful． Right lower abdominal incision length of MLA group was significantly shorter than that of OA group ( P = 0． 000) ; operation time of two groups were similar( P = 0． 070) ; after operation pain score index of MLA group ( 24 h， 48 h， 72 h) was significantly lower than that of OA group ( P = 0． 000) ; preoperative CRP and IL-6 is was similar in MLA group and OA group ( P = 0． 935) ; postoperative( 24 h，72 h) CRP and IL-6 ( P = 0． 000) were lower in MLA group than in OA group; postoperative out-of-bed activity time，postoperative gastrointestinal function recovery time，postoperative hospital stay of MLA group were significantly shorter than those of OA group ( P = 0． 000) ; the postoperative complication rate of the two groups similar( P = 0． 331) ; incision index of MLA group was smaller than that of OA group ( P = 0． 000) ; hospitalization expenses of two groups were similar( P = 0． 195) ． Conclusion Gasless two-port MLA has the advantages of simple operation，less trauma， quicker recovery，shorter hospitalization time，with strong practicability，and is of high clinical value，without cost increasing．