摘要
目的探讨腹腔镜阑尾切除术(Laparoscopic Appendectomy,LA)在学龄前儿童中的运用。方法对2011年1月至2015年12月笔者收治的239例行阑尾切除术的儿童病例进行回顾性分析,其中学龄前儿童55例,学龄儿童184例;采取腹腔镜阑尾切除术116例,开腹阑尾切除术123例。比较采取腹腔镜阑尾切除术的学龄前儿童与其他手术儿童在手术时间、住院时间、切口感染率、腹腔脓肿发生率的差别。结果采用腹腔镜阑尾切除术的学龄前儿童与采用相同手术方式的学龄儿童在手术时间、住院时间、切口感染及腹腔脓肿的发生率上比较,差异无统计学意义(P>0.05)。在病理类型为单纯性阑尾炎的学龄前儿童中,采用腹腔镜手术方式的患儿住院时间明显短于采用开腹手术方式的患儿(P<0.05),手术时间、切口感染及腹腔脓肿的发生率比较,差异无统计学意义(P>0.05)。在病理类型为复杂性阑尾炎的学龄前儿童中,不同手术方式在手术时间、住院时间、切口感染及腹腔脓肿的发生率上比较,差异无统计学意义(P>0.05)。结论腹腔镜阑尾切除术在学龄前儿童中的应用是安全、可行的,与学龄儿童相比较并不会提高切口感染及腹腔脓肿的发生率。与传统开腹手术比较有一定的临床优势,值得推广。
Objetive To explore the apphcation of laparoscopic appendectomy （LA） in preschool chil- dren. Methods For this retrospective study ,239 children undergoing appendectomy were recruited from Janu- ary 2011 to December 2015. They were either pre-school （ n = 55 ） or school-age （ n = 184）. The procedures were LA（ n = 116 ） and traditional open operation（ n = 123 ）. Preschool children of LA were compared with oth- er children in terms of operative duration, hospitalization time, incision infection rate and abdominal abscess rate. Results The pre-school children with the same operative approaches as school-age children had no obvi- ous differences in operative duration, hospitalization time, incision infection rate or abdominal abscess rate （ P 〉 0. 05 ）. In pre-sehool children with simple appendicitis, hospitalization time of LA children were significantly shorter than that of Open operated counterparts （ P 〈 0. 05 ）. And operative duration, incision infection rate and abdominal abscess rate showed no statistical differences（ P 〉 0.05 ）. In pre-school children with complicated ap- pendicitis,different surgical approaches showed no obvious differences in operative duration, hospitalization time, incision infection rate or abdominal abscess rate （ P 〉 0.05 ）. Conclusions LA is both safe and feasible for preschool children. As compared with school - age children,it does not increase the incidence of incision in- fection and abdominal abscess. As compared with traditional approaches,it offers certain clinical advantages. LA is worth wider popularization in preschool children.
出处
《临床小儿外科杂志》
CAS
2016年第5期464-468,共5页
Journal of Clinical Pediatric Surgery
