三孔与单孔腹腔镜切除术式治疗急性阑尾炎合并胆囊结石的疗效对比

Comparison of different kinds of combination of laparoscopic operation in treatment of acute appendicitis complicated with gallbladder stones

摘要:

目的??探讨三孔与单孔腹腔镜胆囊阑尾联合切除术式治疗急性阑尾炎合并胆囊结石临床疗效差异。方法?研究对象选取该院及临汾市人民医院2012年8月-2015年8月收治急性阑尾炎合并胆囊结石患者共110例，以随机抽签法分为对照组（55例）和观察组（55例），分别采用三孔和单孔腹腔镜下胆囊阑尾联合切除术式治疗；比较两组患者手术相关临床指标、Brown手术满意度评分、手术前后抑郁焦虑视觉模拟评分法（VAS）及术后并发症发生率等。结果?观察组患者切口长度明显短于对照组（P <0.05）；观察组患者手术操作用时则明显长于对照组（P <0.05）；观察组患者术后抑郁焦虑VAS评分均明显低于对照组、治疗前（P <0.05）；同时两组患者术后并发症发生率比较差异无统计学意义（P >0.05）。结论?相较于三孔腹腔镜术式，单孔腹腔镜胆囊阑尾微创联合切除治疗急性阑尾炎合并胆囊结石可有效缩短切口长度，改善手术美观性和术后负面情绪，且未导致术后并发症风险上升。

Abstract:

Objective?To investigate the clinical effects differences of three-port and single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone.?Methods?110 patients with acute appendicitis complicated with gallbladder stones from August 2012 to August 2015 were randomly divided into control group (55 patients) with three-port laparoscopic operation and observation group (55 patients) with single-port laparoscopic operation; and the clinical indexes for operation related, operation overall satisfaction score of Brown, the VAS score of depression and anxiety before and after operation and postoperative complications of both groups were compared.?Results?The incision length of observation group was significantly shorter than control group (P < 0.05). The operative time of observation group was significantly longer than control group (P < 0.05). The operation overall satisfaction of Brown of observation group was significantly higher than control group (P < 0.05). The VAS score of depression and anxiety after operation of observation group was significantly better than control group and before operation (P < 0.05). There was no significant difference in the incidence of postoperative complications between 2 groups (P < 0.05).?Conclusion?Compared with three-port laparoscopic operation, single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone can efficiently decrease the incision length, improve the aesthetic degree and postoperative negative emotions and not lead to increased risk of postoperative complications.