双孔腹腔镜与B超引导下穿刺引流治疗阑尾周围脓肿对比分析.docVIP

双孔腹腔镜与B超引导下穿刺引流治疗阑尾周围脓肿对比分析 　　[摘要] 目的 探讨二种不同方法治疗阑尾周围脓肿的临床效果。方法 方便选取并回顾分析该院2013年3月―2015年5月收治的74例阑尾周围脓肿非保守治疗患者的临床资料，36例为双孔腹腔镜手术，38例为B超引导下穿刺引流，比较二组手术时间、排气时间、抗生素使用时间、住院时间、切除率、并发症等指标。结果 二组手术均成功，腹腔镜组无中转开腹，腹腔镜组排气时间、抗生素使用时间、住院时间少于B超组，而手术时间多于B超组，差异有统计学意义（P0.05）。结论 根据病情制定诊疗方案，应用双孔腹腔镜适时对阑尾周围脓肿进行手术治疗是微创、可行、有效的手段，可获得良好的临床效果。而对阑尾周围脓肿合并严重内科疾病的患者，B超引导下穿刺引流具有明确的治疗效果。 　　[关键词] 阑尾周围脓肿；双孔腹腔镜探查；B超引导下穿刺引流 　　[中图分类号] R565 [文献标识码] A [文章编号] 1674-0742（2016）05（c）-0193-03 　　[Abstract] Objective To study the clinical effect of biforate laparoscope and B-ultrasound-guided percutaneous drainage in treatment of periappendiceal abscess. Methods The clinical data of 74 cases of patients with periappendiceal abscess non-conservative treatment in our hospital from March 2013 to May 2015 were retrospectively analyzed， 36 cases were treated with biforate laparoscope operation， 38 cases were treated with B-ultrasound-guided percutaneous drainage， and the operative time， exhaust time， antibiotic application time， length of stay， resection rate and complications were compared between the two groups. Results The operation of both groups was successful， the laparoscope group were not converted to open laparotomy， the exhaust time， antibiotic application time and length of stay in the laparoscope group were less than those in the B-ultrasound group， and the differences had statistical significance（P0.05）. Conclusion We should make diagnosis and treatment programs according to the disease condition， and the biforate laparoscope is a minimal invasive， feasible and effective method in operative treatment of periappendiceal abscess duly， and it can obtain a good clinical effect， but for patients with periappendiceal abscess combined with serious medical diseases， B-ultrasound-guided percutaneous drainage has a definite treatment effect. 　　[Key words] Periappendiceal abscess； Biforate laparoscopic exploration； B-ultrasound-guided percutaneous drainage 　　自从德国妇科教授Semn于1982年完成第1例腹腔镜阑尾切除术后，腹腔镜阑尾切除术逐渐被广大外科医师及患者接受[