老年阑尾炎患者腹腔镜阑尾切除效果观察

摘要

Objective To discuss the effect of minimally invasive laparoscopic surgery in elderly patients with appendicitis . Methods 203 elderly patients with appendicitis in our hospital from December 2005 to December 2009 were assigned to Group LA (72 cases by laparoscopic appendectomy ) and Group OA (131 cases by open appendectomy ). The two groups were compared in operation time, anal exhaust time, use of anodyne , hospital stay, and incidences of postoperative complications . Results Compared with Group OA,the operation time ,anal exhaust time and hospital stay in Group LA was significantly shorter (P < 0.05) ,the use of postoperative analgesics and the incidence of cardiopulmonary complications decreased , and the infection rate of incisional wound decreased . Differences between the two groups were significant (P <0.05). Conclusion Compared with laparoscopic appendectomy ,open appendectomy leads to less trauma,faster recovery of bowel function ,low incidence of complications (such as infection of incisional wound ,fecal leakage) , and shorter hospital stay, and can reduce the incidence of cardiopulmonary complications , which has significant advantages in the treatment of elderly patients with appendicitis .%目的 探讨老年阑尾炎腹腔镜微创手术治疗的效果.方法 2005 年 12 月至 2009 年 12 月我院收治老年阑尾 炎 203 例,其中腹腔镜阑尾切除术(Laparoscopic appendectomy,LA)72 例(LA 组),开腹阑尾切除术(Open appendectomy,OA) 131 例(OA 组),比较两组病例的手术时间、排气时间、镇痛剂使用、住院时间、术后原发合并症的发生及术后并发症情况.结 果 LA 组较 OA 组手术时间、排气时间及住院时间明显缩短,术后镇痛剂应用减少,心肺并发症的发生率及切口感染率较 OA 组低,差异均有统计学意义(P ＜0.05).结论 LA 较 OA 具有创伤小、肠道功能恢复快、并发症发生率低(如切口感染、粪 漏)、住院时间短、能降低心肺并发症的发生等优点,治疗老年人阑尾炎有明显优势.