摘要
目的探讨经脐单孔腹腔镜技术在阑尾切除术中的应用价值及脐部重建的方法。方法本研究为病例对照研究,选取2019年9月至2022年8月天津市西青医院普通外科收治的70例行阑尾切除术患者,男38例,女32例,年龄(32.4±4.4)岁,年龄范围为24~72岁。根据腹腔镜手术方式不同,将患者分为三孔腹腔镜下阑尾切除术(LA)组与经脐单孔腹腔镜下阑尾切除术(SILA)组,每组35例。比较两组患者手术时间、术中出血量、并发症发生率、胃肠功能恢复时间、住院时间、术后48 h疼痛评分[采用视觉模拟评分法(visual analogue scale,VAS)]、术后镇痛药物使用时间、术后伤口美容满意率。结果两组患者手术时间、术中出血量、并发症发生率比较,差异无统计学意义(P>0.05)。SILA组胃肠功能恢复时间[(12.45±3.06)h]、住院时间[(4.01±1.61)d]及术后镇痛药物使用时间[(1.51±0.18)d]均短于三孔LA组[(26.12±2.15)h、(5.32±1.31)d、(3.71±1.79)d],术后48 h VAS评分[(1.79±1.08)分]低于三孔LA组[(5.26±1.12)分],差异均有统计学意义(P<0.05)。SILA组患者术后伤口美容满意度[100%(35/35)]高于三孔LA组[57.2%(20/35)],差异有统计学意义(P<0.05)。结论经脐SILA在阑尾切除术后恢复中患者效果满意,能够缩短患者胃肠功能恢复时间,减少术后镇痛药物使用时间,加速患者康复进程,患者对脐部伤口普遍满意,伤口美容满意度明显提高,值得临床进一步应用。
Objective To explore the application value and clinical effect of transumbilical single-port laparoscopic technique in appendicitis surgery,and to explore the method of umbilical cord reconstruction.Methods This study was a case-control study,a total of 70 patients were selected from the department of General Surgery of Tianjin Xiqing Hospital from September 2019 to August 2022,including 38 males and 32 females,aged(32.4±4.4)years old,ranging from 24 to 72 years old.A random number table was used to divide patients into three-port laparoscopic appendectomy(LA)group and single-port laparoscopic appendectomy(SILA)group,with 35 cases in each group.Operation time,intraoperative blood loss,complication rate,gastrointestinal function recovery time,hospital stay,postoperative pain score 48 h[visual analogue scale(VAS)was used],postoperative analgesic drug use time,postoperative wound beauty satisfaction rate were compared between the two groups.Results There was no significant difference in operation time,intraoperative blood loss and complication rate between the two groups(P>0.05).Gastrointestinal function recovery time[(12.45±3.06)h],hospitalization time[(4.01±1.61)d]and postoperative analgesic drug use time[(1.51±0.18)d]in SILA group were shorter than those in three-port LA group[(26.12±2.15)h,(5.32±1.31)d,(3.71±1.79)d],the VAS score at 48 h after operation[(1.79±1.08)points]was lower than that of three-port LA group[(5.26±1.12)points],and the differences were statistically significant(P<0.05).The satisfaction of postoperative wound beauty in SILA group[100%(35/35)]was higher than that in three-port LA group[57.2%(20/35)],and the difference was statistically significant(P<0.05).Conclusions The effect of transumbilical single-port laparoscopic technique in the postoperative recovery of patients with appendicitis surgery is satisfactory,which can shorten the recovery time of patients'gastrointestinal function,reduce the use of postoperative analgesic drugs,and accelerate the rehabilitation process of patients.Patients are generally satisfied with umbilical wounds,and the satisfaction of wound beauty is significantly improved,which is worthy of further clinical application.
作者
黄涛
贾学伟
刘汉博
刘翔宇
张勇强
Huang Tao;Jia Xuewei;Liu Hanbo;Liu Xiangyu;Zhang Yongqiang(Department of General Surgery,Tianjin Xiqing Hospital,Tianjin 300380,China)
出处
《中国临床实用医学》
2024年第2期57-61,共5页
China Clinical Practical Medicine
关键词
阑尾切除术
经脐单孔腹腔镜技术
脐部重建
伤口美容
Appendectomy
Transumbilical single-port laparoscopic technique
Umbilical reconstruction
Wound beauty
作者简介
通信作者:黄涛,Email:htwww2008@126.com。
