摘要
目的:回顾性比较腹腔镜(LA)与开腹(OA)阑尾切除术治疗老年急性阑尾炎患者的效果和综合治疗费用等,进一步探讨LA在老年患者中的应用价值。方法:收集2012年12月至2017年3月收治的老年急性阑尾炎患者243例的一般资料,按手术类型分为腹腔镜手术组(LA组)96例和开腹手术组(OA组)147例。分析两组手术时长、切口大小、手术出血量、术后下床所需时长、肛门排气所需时长、引流所需时长、导尿所需时长、抗生素使用持续时间、止痛针使用比例、住院时间、恢复正常活动时间、30 d内再入院例数、术后并发症、住院费用、患者对于手术的满意度以及再次选择度等。结果:LA组在切口长度、术中出血量、下床时间、术后排气、引流、导尿时间、术后抗生素及止痛药使用时间、住院天数、术后并发症等指标上均优于OA组,差异有统计学意义(P<0.05)。LA组在手术疼痛、住院费用、术后生活质量、术后恢复时间、再次选择满意度评价上高于OA组,差异有统计学意义(P<0.05)。结论:虽然,LA治疗老年急性阑尾炎患者的综合治疗费用较高、手术时间较长,但具有创伤小、恢复快、并发症发生率低、住院时间短、患者满意度高等优点。LA在老年患者中应用安全,是治疗老年急性阑尾炎患者的推荐手术方式。
Objective:To retrospectively compare laparoscopic appendectomy(LA)and open appendectomy(OA)in the treatment of elderly patients with acute appendicitis and the cost of comprehensive treatment and others in order to further explore the application value of LA in elderly patients.Methods:General data of 243 elderly patients with acute appendicitis admitted from December 2012 to March 2017 were collected,and according to the type of surgery,the patients were divided into a laparoscopic appendectomy group(LA group)with 96 cases and an open appendectomy group(OA group)with 147 cases.The length of surgery,the size of the incision,the amount of bleeding in surgery,the length of time required to get out of bed after surgery,the length of time required for anal exhaust,the length of time required for drainage,the length of time required for catheterization,the duration of antibiotic use,proportion of analgesic needles used,hospitalization time,time to resume normal activity,number of re-admissions within 30 days,postoperative complications,hospitalization costs,patient satisfaction with surgery,and degree of reselection were analyzed.Results:The LA group was superior to the OA group in terms of incision length,intraoperative bleeding volume,time to get out of bed,postoperative exhaust,drainage,catheterization time,postoperative antibiotic and analgesic use time,hospitalization days and postoperative complications,and the difference was statistically significant(P<0.05).The LA group was higher than the OA group in terms of operation pain,hospitalization expenses,quality of life after operation,recovery time after operation and satisfaction evaluation of re-selection,and the difference was statistically significant(P<0.05).Conclusion;Although the comprehensive treatment of LA for elderly patients with acute appendicitis is expensive and the operation time is long,it has the advantages of small trauma,quick recovery,low incidence of complications,short hospitalization time and high patient satisfaction.LA is safe for use in elderly patients and is the recommended surgical procedure for the treatment of elderly patients with acute appendicitis.
作者
冯少问
叶桃
陈文杰
王会鹏
陆品相
蔡元坤
FENG Shaowen;YE Tao;CHEN Wenjie;WANG Huipeng;LU Pinxiang;CAI Yuankun(Department of General Surgery of Central Hospital of Xuhui District,Shanghai 200031,China;Department of General Surgery of the Fifth People’s Hospital affiliated to Shanghai Fudan University,Shanghai 200240,China)
出处
《上海医药》
CAS
2019年第16期22-25,36,共5页
Shanghai Medical & Pharmaceutical Journal
关键词
急性阑尾炎
阑尾切除术
腹腔镜
老年人
acute appendicitis
appendectomy
laparoscope
elderly people
