目的:探讨腹腔镜阑尾切除术中阑尾根部结扎、阑尾根部荷包包埋、hem-o-lok夹闭三种常见的处理方式对患者的治疗效果,为腹腔镜阑尾炎患者提供个性化治疗方案。方法:回顾2022年5月~2023年5月,于北华大学附属医院普通外科,因急性阑尾炎伴或不伴有局限性腹膜炎收入我科,且行腹腔境阑尾切除术的患者为研究对象,根据术中阑尾处理方式的情况,将研究对象分为三组,阑尾根部结扎组(A组),阑尾根荷包包埋组(B组),hem-o-lok夹闭组(C组),并收集三组患者临床资料(手术时间,术后镇痛药物使用率,术后患者下地活动时间,术后排气时间、术后患者有无术后并发症)比较分析。结果:三组患者共纳入156人,其中A组52人,B组56人,C组48人。三组患者术后下地活动时间,排气时间,术后镇痛药物使用,均无统计意义(P > 0.05)。术后并发症回顾分析,统计术后出现阑尾残株炎、阑尾残端瘘、腹盆腔脓肿的患者均为零,未发生上述并发症。根据数据统计分析仅在手术时间上存在差异(P Objective: To explore the therapeutic effects of three common treatment methods in laparoscopic appendectomy, such as appendectomy root ligation, appendectomy root bag embedding and hem-o-lok clamp, in order to provide personalized treatment who have laparoscopic appendicitis. Method: The patient was admitted to the General Surgery Department of the Affiliated Hospital of Beihua University from May 2022 to May 2023 who underwent abdominal appendectomy due to acute appendicitis with or without circumstantial peritonitis were reviewed as the study subjects. Treatment of the appendix is divided into three groups: Appendix root ligation group (group A). Appendectomy root bag embedding group (group B) and hem-o-lok clamp group (group C) were compared and analyzed. Collecting clinical data (operation time, postoperative analgesic drug utilization rate, postoperative movement time, postoperative exhaust time, postoperative
目的:观察腹腔镜阑尾切除术治疗阑尾周围脓肿保守治疗不佳患者的疗效。方法:对北华大学附属医院普外二科收治的7例阑尾周围脓肿经保守治疗后予腹腔镜对阑尾周围脓肿切开引流术联合阑尾切除术。结果:7例患者均一期腹腔镜手术完成,阑尾完整切除,平均时长90分钟,未中转开腹,患者术后均恢复良好并出院。结论:腹腔镜下阑尾周围脓肿切开引流术联合阑尾切除术,加速患者疾病康复,减轻炎症反应,改善预后,对治疗阑尾周围脓肿治疗安全、有效,可以应用及推广。Objective: To observe the efficacy of laparoscopic appendectomy in the treatment of periappendicular abscess in patients with poor conservative treatment. Methods: 7 cases of periappendiceal abscess were treated by laparoscopic incision and drainage combined with appendectomy after conservative treatment in the second Department of General Surgery, Affiliated Hospital of Beihua University. Results: All of the 7 patients underwent one-stage laparoscopic surgery and complete appendectomy, with an average duration of 90 minutes, without conversion to laparotomy. All patients recovered well after surgery and were discharged from hospital. Conclusion: Laparoscopic incision and drainage combined with appendectomy can accelerate the recovery of the disease, reduce the inflammatory response and improve the prognosis. It is safe and effective for the treatment of periappendicular abscess, and can be applied and popularized.
