腹腔镜阑尾切除术和传统开腹阑尾切除术的临床对比分析-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 腹腔镜阑尾切除术和传统开腹阑尾切除术的临床对比分析 研究生：迪里夏提·阿力木 导师：克力木·阿布都热依木教授 摘 要 目的：探讨腹腔镜阑尾切除术(Laparoscopic appendectomy,LA)在治疗阑尾炎中的 可行性及优越性。方法：对 2004 年 1 月至 2008 年 11 月我科施行的 61 例腹腔镜阑 尾切除术和 97 例开腹阑尾切除术的临床资料进行回顾性对比分析，比较两组手术时 间、出血量、住院时间、切口大小、术后抗生素使用时间、住院费用、切口感染率 及腹腔引流管留置率。结果：腹腔镜组 58 例成功施行腹腔镜手术，有 3 例中转开腹， 平均手术时间为 35.52±10.20min，开腹组平均手术时间为 63.14±11.45min，两组差异 有统计学意义(p=0.000，p0.05)；术中出血量腹腔镜组平均为 10.3±14.5ml，开腹组 平均为 19.2±16.4ml，两组差异有统计学意义(p=0.000，p0.05)；腹腔镜组平均住院 日为 7.4±3.1d，开腹组平均住院日为 7.1±3.9d，两组差异无统计学意义(p=0.631， p0.05)；切口大小腹腔镜组平均为 2.5±0.5cm，开腹组平均为 4.2±1.2cm，两组差异 有统计学意义(p=0.000，p0.05)；腹腔镜组平均术后抗生素使用时间为 3.1±1.4d，开 腹组为 3.7±1.9d，两组差异有统计学意义(p=0.043，p0.05)；住院费用腹腔镜组平均 为 6102.65±1597.48 元，开腹组平均为 3086.23±2069.57 元，两组差异有统计学意义 (p=0.000，p0.05)；腹腔镜组切口感染率为 0.00%，开腹组切口感染率为 4.1%，两 组差异无统计学意义(p=0.160，p0.05)，腹腔镜组引流管留置率为 3.4%，开腹组引 流管留置率为 15.5%，两组差异有统计学意义(p=0.021，p0.05)。结论：腹腔镜阑尾 切除术治疗阑尾炎和开腹阑尾切除术相比，具有创伤小、疼痛轻、恢复快、美容效 果好及并发症少等优点，特别适用于肥胖者及育龄期妇女，是治疗阑尾炎较理想的 手术方式。 关键词：腹腔镜；阑尾炎；阑尾切除术 新疆医科大学医学硕士学位论文 Comparative Clinical Analysis of Laparoscopic Appendectomy andTraditional Open Appendectomy Abstract Objective To study the feasibility and superiority of laparoscopic appendectomy. Methods 61 cases of laparoscopic appendectomy and 97 cases open appendectomy were performed from January 2004 to November 2008.Perioperative data and follow-up results were collected and compared in two groups.Results Of 61 patients, 58 cases were operated on by laparoscopic appendectomy,3 cases were converted to open laparotomy.Mean operation time of LA group were 35.52±10.20min，mean operation time of OA group were 63.14±11.45min,there were significantly different between two groups(p=0.000，p0.05);The mean blood lost of LA group were 10.3±14.5ml,OA group were 19.2±16.4ml, there were significantly different between two groups(p=0.000， p0.05); The mean hospital stay of LA group were 7.4±3.1d,OA group were 7.1±3.9d, there were no significantly different between two groups(p=0.631，p0.05);The length of incision in LA group