关键词: 腹腔镜阑尾切除术, 开腹阑尾切除术, 根部坏疽穿孔性阑尾炎, 临床疗效

Abstract: Objective To study and compare the clinical effects of laparoscopic appendectomy(LA)and open appendectomy(OA)in the treatment of acute gangrenous appendicitis with root perforation.
Methods Review and analysis the data of 67 patients of gangrenous appendicitis with root perforation received in my hospital from July 2013 to June 2019 were divided into two groups,including 36 cases in LA group and 31 cases in OA group,2 cases changed from LA to OA.The treatment effect was analyzed and compared such as the mean intraoperative time,bleeding volume and postoperative intestinal ventilation time,extubation time,incidence of complications,average hospitalization days and hospitalization costs.
Results Patients in LA group and OA group were cured and discharged from hospital.The mean intraoperative time of LA was(83.17±31.54)min,bleeding volume was(6.59±5.91)ml and postoperative intestinal ventilation time was(2.56±0.92)d ,which was less than OA group[(104.97±47.40)min,(30.09±22.76)ml and(3.38±2.40)d].Extubation time,hospitalization day and hospitalization cost in LA was(2.67±0.64)d、(7.02±1.58)d、(15 561±3 191)RMB,but in OA was(4.13±2.46)d,(12.55±7.57)d and(18 924±12 252)RMB(P＜0.05).The incidence of complications average in LA was 14.70% ,which is less than 35.48% in OA,the difference is statistically significant(All P<0.05).
Conclusion LA and OA both have good effects;however,LA is much better than OA in operation time,less intraoperative bleeding,lower operative complications,faster postoperative recovery.And minimally invasive surgery is the trend of surgical development at present.If the medical equipment and technology is prepared well,LA can be used as a perfect treatment for acute gangrenous appendicitis with root perforation.

Key words: laparoscopic appendectomy, open appendectomy, appendicitis perforated with root gangrene, clinical effects