三种不同戳孔入路在腹腔镜阑尾切除术中的对比研究

doi:10.3969/j.issn.1005-6483.2019.12.008

摘要/Abstract

摘要： 目的比较3种不同戳孔入路腹腔镜阑尾切除术的疗效。方法 2017年1月～2018年12月收治的急性阑尾炎病人120例，将120例病人随机分为3组，每组各40例，采取3种不同戳孔入路行腹腔镜阑尾手术。第1组：脐孔、麦氏点、耻骨联合上方；第2组：脐孔、反麦氏点、耻骨联合上方；第3组：脐孔、耻骨联合左右。比较各组间手术时间、术后并发症、术后疼痛、住院天数及术后满意度。结果第1组手术时间为（51.13±20.05）分钟，第2组（49.79±19.24）分钟，第3组（58.00±15.14）分钟，第1组和第2组间比较，差异无统计学意义（P＞0.05），第2组手术时间少于第3组，差异有统计学意义（P＜0.05）。术后并发症：第1组、第2组和第3组出现术后并发症分别为5例、2例和4例，3组间比较差异无统计学意义（P＞0.05）。第1组术后6小时，12小时，24小时术后疼痛VAS值分别为5.54±1.45、5.15±1.23和4.08±0.92；第2组分别为5.10±1.26、4.78±1.12和3.78±1.05；第3组分别为5.35±1.67、5.05±0.96和4.10±1.08。3组间比较差异均无统计学意义（P＞0.05）。第1组住院时间为（5.89±2.77）天，第2组为（5.85±1.85）天，第3组为（5.52±1.83）天，三组间比较差异无统计学意义（P＞0.05）。第3组术后满意度最好，差异有统计学意义（P＜0.05）。结论 3种戳孔入路均适用于腹腔镜阑尾切除术，对于外观要求较高病人，脐孔、耻骨联合左右戳孔可作为首选入路。

关键词: 腹腔镜, 阑尾切除术

Abstract: Objective To study the different position of the trocars in laparoscopic appendectomy.Methods From January 2017 to December 2018，a total of 120 appendicitis patients were randomly divided into 3 groups，40 cases in each group.In group one，trocar one was inserted through umbilicus，trocar two was inserted at McBurney's point，and trocar three was inserted above the pubic symphysis.In group two，trocar one was inserted through umbilicus，trocar two was inserted at the reverse McBurney's point，and trocar three was inserted above the pubic symphysis.In group three，trocar one was inserted through umbilicus，trocar two was inserted above the left side of the pubic symphysis，trocar three was inserted above the right side of the pubic symphysis.The operative time，the rates of complications，the inpatient stay，the postoperative ache degree and the postoperative satisfaction among the three groups were compared.Results Operative time：the first group was（51.13±20.05）min，the second group was（49.79±19.24）min and the third group was（58.00±15.14）min.There was no significant difference in the operation time between group one and group two（P>0.05），and group two was significantly less than group three（P<0.05）.Postoperative complications：there were 5 complications in the first group，2 complications in the second group and 4 complications in the third group.There was no significant difference among the three groups（P> 0.05）.The pain scores assessed by VAS at 6，12 and 24 hours were as follws：（5.54±1.45），（5.15±1.23），（4.08 ±0.92）in group one，（5.10±1.26），（4.78±1.12），（3.78±1.05）in group two and（5.35±1.67），（5.05±0.96），（4.10±1.08）in group three.Days of hospitalization：the first group was（5.89 ±2.77）days，the second group was（5.85 ±1.85）days，and the third group（5.52±1.83）days.There was no significant difference among the three groups（P>0.05）.There was no significant difference in the postoperative ache degree among the three groups（P>0.05），but the third group had the best postoperative satisfaction（P<0.05）.Conclusion These three different trocar positions are safe and feasible for appendicitis.Group three is more suitable for cosmetic results.

Key words: laparoscopic surgical procedures, appendectomy

孙静秋, 朱从元, 王珂, 华玉明. 三种不同戳孔入路在腹腔镜阑尾切除术中的对比研究[J]. 临床外科杂志, 2019, 27(12): 1037-1040.

SUN Jingqiu, ZHU Congyuan, WANG Ke, et al.. A comparative study of three different trocar positions in laparoscopic appendectomy[J]. JOURNAL OF CLINICAL SURGERY, 2019, 27(12): 1037-1040.

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