目的 探讨腹腔镜阑尾切除术的临床经验和应用价值。方法 回顾性分析腹腔镜二孔法阑尾切除术 39例(二孔法组)和三孔法阑尾切除术70例(三孔法组)的临床资料。结果 顺利完成手术107例； 中转开腹2例,其中阑尾严重粘连1例,腹膜后阑尾1例。术后发生粘连性肠梗阻1例,经保守治疗痊愈出院。住院时间2~9 d,平均3 d。随访全部患者2~24个月,平均12个月,未发生其他并发症。结论 腹腔镜阑尾切除术具有创伤少、并发症发生率低及恢复快的优点,将成为阑尾切除术的首选术式。腹腔镜二孔法阑尾切除术操作简单,易于推广; 三孔法则具有处理复杂阑尾切除术的优势。
目的 探讨三孔法腹腔镜胆囊阑尾联合切除术的临床价值。 方法 对64例胆囊良性病变合并急、慢性阑尾炎患者实施三孔法胆囊阑尾腹腔镜联合切除的临床资料进行分析。结果 64例均获成功，手术时间40~80 min，术后3~5 d出院，无并发症发生。结论 三孔法腹腔镜胆囊阑尾联合切除术具有创伤小、痛苦少、恢复快、住院时间短等优点，治疗胆囊阑尾良性疾病安全可靠，并可有效降低医疗费用。
ObjectiveTo summarizes the clinical characteristics of chronic appendicitis in children and discusses the diagnostic methods and the clinical application value of laparoscopic surgery.MethodsThe clinical data and treatment process of 68 children with chronic appendicitis admitted to the First Affiliated Hospital of Anhui Medical University from January 2015 to January 2020 were retrospectively analyzed, and their clinical characteristics and treatment experience were summarized and analyzed.ResultsAccording to different medical histories and symptoms, 68 cases were divided into 3 groups, with 15 patients in the typical symptom group, 28 patients in the appendix abscess group, and 25 patients in the asymptomatic group. All the 25 children in the asymptomatic group underwent barium enema examination, among which 68.0% (17/25) had filling defect in the appendix cavity, 16.0% (4/25) had no obvious appendix visualization, and 68.0% (17/25) had residual barium in the appendix cavity after 72 hours. The incidence of children in the 3 groups was concentrated at school age, but there was no significant difference in the proportion of children in different age groups between the three groups (P>0.05). All cases underwent laparoscopic exploration, 66 cases successfully completed laparoscopic appendectomy, 2 cases transferred to laparotomy, and all recovered satisfactorily. There was no statistically significant difference in the incidence of postoperative complications between the 3 groups (P>0.05).ConclusionsThe clinical manifestations of chronic appendicitis in children are diverse and difficult to diagnose. Barium enema examination (including re-examination after 72 hours) in children with atypical symptoms can help confirm the diagnosis. Chronic appendicitis in children is more common in school-age children, and laparoscopic exploration+appendectomy are the preferred treatment.
的报道楔形切开浆肌层的全阑尾切除术的临床应用体会。方法对72例根部肿胀增粗、坏疽穿孔合并盲肠壁增厚的急、慢性阑尾炎，从基底部楔形切开盲肠浆肌层，进行全阑尾切除术。结果该72例中无一例发生粪瘘、残端出血、残株炎及肠粘连等并发症。 结论合理应用从基底部楔形切开盲肠浆肌层的全阑尾切除术可有效预防根部肿胀增粗、坏疽穿孔的阑尾切除术后的粪瘘、残端出血、残株炎及肠粘连等并发症。
In order to inquire into the relation between bacterial L-forms and chronic appendictis,appendices removed from 10 patients with appendicitis were cultured with improved kagans’s solid medium and nutrient medium containing blood respectively.Bacterial forms with bacterial L-form transforms to L-forms and 1 strain of bacillus aerogen with its L-form.The result shows that bacterial form transforms to L-form,then to bacterial form may be related with appendicitis attack,alleviation and attack again.
目的探讨碘伏原液浸泡对于预防阑尾Ⅲ类手术切口手术部位感染（SSI）的疗效。 方法回顾性分析笔者所在医院2012年5月至2013年5月期间施行阑尾切除术者中切口类型为Ⅲ类的92例患者的临床资料，比较以碘伏原液浸泡切口（浸泡组）和冲洗切口（常规组）处理后患者的切口愈合情况。 结果术后常规组57例患者中，有43例切口愈合等级为甲级，5例为乙级，9例为丙级，SSI发生率为24.56%（14/57）。浸泡组35例患者的切口愈合均良好，均为甲级愈合，SSI发生率为0，低于常规组（P<0.05）。 结论采用碘伏原液浸泡切口5 min能有效预防阑尾炎Ⅲ类切口SSI的发生，值得临床推广应用。
ObjectiveTo explore the curative effect and value of laparoscopic operation in the treatment of acute gangrenous and perforated appendicitis. MethodsThe clinical data of 243 patients with acute gangrenous and perforated appendicitis from February 2011 to February 2014 in our hospital were retrospectively analyzed. Laparoscopic appendectomy was performed in 118 cases (LA group), and open appendectomy was performed in 125 cases (OA group). The operative time, hospital stay, hospital costs, incision bleeding, gastrointestinal function recovery, wound infection, pelvic abscess, and postoperative adhesions of two groups were compared. ResultsThere was no significant difference in the operative time, incision bleeding, and the incidence of pelvic abscess after operation between the LA group and OA group (P>0.05). Compared with the OA group, the recovery time of gastrointestinal function was significantly shortened (P<0.01), eating time was earlier (P<0.01), hospitalization time also shortened significantly (P<0.01), and the incidence of postoperative wound infection and intestinal adhesion were significantly decreased (P<0.01) after operation in LA group. But the cost of hospitalization in LA group increased significantly (P<0.05). ConclusionsThe laparoscopic operation in the treatment of gangrenous and perforated appendicitis are light of pain., recover quickly, shorter of hospital stay, and fewer complications. The increase of hospitalization expenses is the only deficiency.