单孔与传统多孔腹腔镜阑尾切除术的临床应用比较*

Clinical application of single-hole and traditional multi-hole laparoscopic appendectomy*

摘要:

摘要：目的 比较单孔与传统多孔腹腔镜阑尾切除术的临床应用效果。方法 研究阶段为2015年1月1日－2017年2月1日，共纳入研究对象121例进行回顾性分析，均为确诊为急性阑尾炎并择期行腹腔镜阑尾切除术患者，行单孔腹腔镜阑尾切除术患者作为观察组（n =61），行传统多孔腹腔镜阑尾切除术患者作为对照组（n =60），比较两组临床效果。结果 对照组与观察组术中出血量、胃肠功能恢复时间和住院时间比较，差异均无统计学意义（P >0.05）。观察组手术时间（75.62±8.56）min长于对照组手术时间（42.56± 6.36）min，差异有统计学意义（P <0.05）。对照组组内比较，视觉模拟评分（VAS）术前、术后差异有统计学意义（P <0.05）。观察组组内比较，VAS评分术前、术后差异有统计学意义（P <0.01）。两组组间比较，对照组与观察组术前VAS评分差异无统计学意义（P >0.05），两组术后差异有统计学意义（P <0.05）。对照组、观察组两组并发症发生差异有统计学意义（P <0.05）。两组术后切口感染差异无统计学意义（P >0.05）。对照组总满意44例（73.33%）明显低于观察组总满意60例（98.36%），差异有统计学意义（P <0.05）。结论 针对急性阑尾炎患者可考虑采用单孔腹腔镜手术，可有效减轻术后疼痛，提高患者对腹部伤口的满意度，降低术后并发症发生率，值得临床应用与推广。

Abstract:

Abstract: Objective To compare the clinical application and made a meta-analysis of single-hole and traditional laparoscopic appendectomy. Methods The study period was from January 1, 2015 to February 1, 2017. 121 patients were enrolled in the retrospective analysis. All the patients were diagnosed as acute appendicitis and underwent elective laparoscopic appendectomy. The patients who underwent single-hole appendectomy as observation group (n = 61), while the patients underwent traditional multi-laparoscopic appendectomy as control group (n = 60). The clinical effects were compared between the two groups. Results There was no significant difference between the control group and the observation group in intraoperative blood loss, gastrointestinal function recovery time and hospital stay (P > 0.05). The operation time of the observation group (75.62 ± 8.56) min was significantly longer than that of the control group (42.56 ± 6.36) min, with statistical significance (P < 0.05).The comparison of VAS score before and after operation in control group was significant different, with statistical significance, P < 0.05. The comparison of VAS score before and after operation in observation group was significant different, with statistical significance (P < 0.01). There was no significant difference in VAS score before operation between the two groups (P > 0.05). There was significant differences in VAS score after operation between the two groups (P < 0.05). There were significant differences in the complication between the two groups, with statistical significance (P < 0.05). There was no significant difference in incision infection between the two groups (P > 0.05). In the control group, 44 cases (73.33%) were satisfied in the observation group and 60 cases (98.36%) were satisfied in the observation group. The difference was statistically significant (P < 0.05). Conclusion The single-hole laparoscopic surgery for patients with acute appendicitis can be considered to reduce postoperative pain, improve patients’ satisfaction with abdominal wounds and reduce postoperative complications, which is worthy of clinical application and promotion.