经脐单孔与常规三孔腹腔镜阑尾切除术的比较(1)
【摘要】 目的 探讨经脐单孔腹腔镜阑尾切除术(SPLA)与常规三孔腹腔镜阑尾切除术(TPLA)的临床价值。方法 62例阑尾炎患者， 随机分为SPLA组和TPLA组， 各31例。SPLA组行经脐SPLA治疗， TPLA组行TPLA治疗， 比较两组患者临床治疗情况及并发症发生情况。结果 SPLA组切口长度为(2.50±0.41)cm， 短于TPLA组的(2.70±0.32)cm， 差异具有统计学意义(P<0.05)。SPLA组手术时间、术中出血量、术后排气时间和住院时间分别为(58.81±11.29)min、(26.13±7.55)ml、(23.39±4.12)h、(5.12±1.43)d， TPLA组手术时间、术中出血量、术后排气时间和住院时间分别为(56.01±10.32)min、(25.88±6.21)ml、(23.12±4.23)h、(5.23±1.34)d， 两组比较差异无统计学意义(P>0.05)。SPLA组患者术后并发症发生率为12.90%， TPLA组患者术后并发症发生率为19.35%， 比较差异无统计学意义(P>0.05)。结论 与TPLA相比， 经脐SPLA的手术方式可以缩小手术切口长度， 同时安全性有保证， 临床上值得应用推广。
【关键词】 腹腔镜;阑尾切除术;单孔;三孔;临床疗效
DOI：10.14163/j.cnki.11-5547/r.2019.01.008
【Abstract】 Objective To discuss the clinical value of transumbilical single-port laparoscopic appendectomy (SPLA) and conventional three-port laparoscopic appendectomy (TPLA). Methods A total of 62 appendicitis patients were randomly divided into SPLA group and TPLA group， with 31 cases in each group. SPLA group received transumbilical SPLA therapy， and TPLA group received conventional TPLA therapy. The clinical treatment condition and occurrence of complications between the two groups was compared. Results SPLA group had shorter incision length as (2.50±0.41) cm than (2.70±0.32) cm in TPLA group， and the difference was statistically significant (P<0.05). SPLA group had operation time， intraoperative bleeding volume， postoperative venting time and hospitalization time respectively as (58.81±11.29) min， (26.13±7.55) ml， (23.39±4.12) h and (5.12±1.43) d， which were (56.01±10.32) min， (25.88±6.21) ml， (23.12±4.23) h and (5.23±1.34) d in TPLA group， and their difference was not statistically significant (P>0.05). SPLA group had incidence of postoperative complications as 12.90%， which was 19.35% in TPLA group， and the difference was not statistically significant (P>0.05). Conclusion Compared with TPLA， transumbilical SPLA approach can shorten the length of incision and ensure safety. So it is worthy of clinical application and promotion.
【Key words】 Laparoscopic; Appendectomy; Single-port; Three-port; Clinical efficacy
急性闌尾炎是临床上常见的急腹症， 目前主要的治疗手段是腹腔镜下阑尾切除术， 其临床效果得到广大医生和患者的肯定。但随着患者对微创伤口以及术后美观性要求的提高， 常规三孔腹腔镜阑尾切除术(three-port laparoscopic appendectomy， TPLA)已经无法满足临床需求。随着医疗技术发展， 近年来， 单孔腹腔镜阑尾切除术(single-port laparoscopic appendectomy， SPLA)也被越来越多的医生采用， 但其临床疗效及安全性尚不明确。本研究主要探讨两种不同方式腹腔镜阑尾切除术在临床治疗中的应用价值， 现报告如下。
1 资料与方法
1. 1 一般资料 选取2016年1月～2018年1月于本院就诊的阑尾炎患者62例。纳入标准：①符合中华医学会阑尾炎诊断标准;②病程<3 d;③既往无阑尾炎发作病史。排除标准：①有腹部手术史;②体质量指数(BMI)>27 kg/m2;③合并腹水、腹腔恶性肿瘤。将患者随机分为SPLA组和TPLA组， 各31例。两组患者一般资料比较， 差异无统计学意义(P>0.05)， 具有可比性。见表1。本研究已充分告知患者并经本院伦理委员会审批。, http://www.100md.com(江树嵩 魏文波 陈新桂)
【关键词】 腹腔镜;阑尾切除术;单孔;三孔;临床疗效
DOI：10.14163/j.cnki.11-5547/r.2019.01.008
【Abstract】 Objective To discuss the clinical value of transumbilical single-port laparoscopic appendectomy (SPLA) and conventional three-port laparoscopic appendectomy (TPLA). Methods A total of 62 appendicitis patients were randomly divided into SPLA group and TPLA group， with 31 cases in each group. SPLA group received transumbilical SPLA therapy， and TPLA group received conventional TPLA therapy. The clinical treatment condition and occurrence of complications between the two groups was compared. Results SPLA group had shorter incision length as (2.50±0.41) cm than (2.70±0.32) cm in TPLA group， and the difference was statistically significant (P<0.05). SPLA group had operation time， intraoperative bleeding volume， postoperative venting time and hospitalization time respectively as (58.81±11.29) min， (26.13±7.55) ml， (23.39±4.12) h and (5.12±1.43) d， which were (56.01±10.32) min， (25.88±6.21) ml， (23.12±4.23) h and (5.23±1.34) d in TPLA group， and their difference was not statistically significant (P>0.05). SPLA group had incidence of postoperative complications as 12.90%， which was 19.35% in TPLA group， and the difference was not statistically significant (P>0.05). Conclusion Compared with TPLA， transumbilical SPLA approach can shorten the length of incision and ensure safety. So it is worthy of clinical application and promotion.
【Key words】 Laparoscopic; Appendectomy; Single-port; Three-port; Clinical efficacy
急性闌尾炎是临床上常见的急腹症， 目前主要的治疗手段是腹腔镜下阑尾切除术， 其临床效果得到广大医生和患者的肯定。但随着患者对微创伤口以及术后美观性要求的提高， 常规三孔腹腔镜阑尾切除术(three-port laparoscopic appendectomy， TPLA)已经无法满足临床需求。随着医疗技术发展， 近年来， 单孔腹腔镜阑尾切除术(single-port laparoscopic appendectomy， SPLA)也被越来越多的医生采用， 但其临床疗效及安全性尚不明确。本研究主要探讨两种不同方式腹腔镜阑尾切除术在临床治疗中的应用价值， 现报告如下。
1 资料与方法
1. 1 一般资料 选取2016年1月～2018年1月于本院就诊的阑尾炎患者62例。纳入标准：①符合中华医学会阑尾炎诊断标准;②病程<3 d;③既往无阑尾炎发作病史。排除标准：①有腹部手术史;②体质量指数(BMI)>27 kg/m2;③合并腹水、腹腔恶性肿瘤。将患者随机分为SPLA组和TPLA组， 各31例。两组患者一般资料比较， 差异无统计学意义(P>0.05)， 具有可比性。见表1。本研究已充分告知患者并经本院伦理委员会审批。, http://www.100md.com(江树嵩 魏文波 陈新桂)