【摘 要】目的：探讨开腹与腹腔镜阑尾切除术治疗急性坏疽性阑尾炎伴弥漫性腹膜炎的临床疗效。方法：选取2015年7月～2018年1月在我院择期行手术的74例急性坏疽性阑尾炎合并弥漫性腹膜炎患者，按手术方式平均分为两组各37例。观察组行腹腔镜阑尾切除术，对照组行开腹阑尾切除术。比较两组患者的治疗效果及安全性。结果：观察患者的手术时间、出血量及切口长度三项指标值均优于对照组；观察组患者术后排气时间、下床活动时间、导尿管插管时间、腹腔引流时间与住院时间均短于对照组；观察组并发症发生率相比对照组明显降低，比较差异有统计学意义(P<0.05)。结论：采用腹腔镜手术治疗急性坏疽性阑尾炎伴弥漫性腹膜炎，效果显著，安全性高，值得临床推广应用。

    【关键词】开腹；腹腔镜；阑尾切除术；急性坏疽性阑尾；弥漫性腹膜炎

    Abstract Objective： To investigate the clinical efficacy of open and laparoscopic appendectomy in the treatment of acute gangrenous appendicitis with diffuse peritonitis.Methods：Seventy-four patients with acute gangrenous appendicitis combined with diffuse peritonitis who were undergoing elective surgery in our hospital from July 2015 to January 2018 were divided into two groups according to the surgical method. The observation group underwent laparoscopic appendectomy and the control group underwent open appendectomy. The treatment effect and safety of the two groups of patients were compared.Results： Observed the patient's operative time ......