经肠镜逆行阑尾造影及治疗术的临床应用观察.docVIP

经肠镜逆行阑尾造影及治疗术的临床应用观察 　　[摘要] 目的 探讨经肠镜逆行阑尾造影及治疗术（Endoscopic Retrograde Appendicitis Therapy，ERAT）在疑诊急性阑尾炎腹痛中的临床诊治效果及安全性。 方法 将32例临床疑诊急性阑尾炎腹痛的患者按随机自愿原则分为治疗组（n=17）及对照组（n=15）。对照组常规行腹腔镜阑尾切除手术（laparoscopic appendectomy，LA），治疗组肠道准备后行结肠镜下逆行阑尾造影术，并根据具体情况选择行阑尾粪石清理、支架引流、清洗?@尾腔等操作，比较临床应用效果及安全性。 结果 治疗组患者无一例发生并发症，与对照组无显著差异（P0.05），但治疗组平均住院费用低[（5401.07±916.69）元 vs （8217.67±1313.02）元]，术后体温恢复快[（6.81±3.89）h vs （34.21±9.78）h]，白细胞恢复正常快[（1.50±0.73）d vs （3.00±0.88）d]，平均住院天数短[（1.06±0.25）d vs （5.50±1.70）d]，均与对照组有显著差异（P0.01）。 结论 经结肠镜逆行阑尾炎造影及治疗术对疑似急性阑尾炎腹痛具有良好的诊断价值，并具有微创、恢复快及安全等优点。 　　[关键词] 急性阑尾炎；内镜下逆行阑尾炎治疗术；腹腔镜阑尾切除手术 　　[中图分类号] R656.8 [文献标识码] B [文章编号] 1673-9701（2017）04-0054-04 　　Effects of endoscopic retrograde appendicitis therapy on acute appendicitis 　　TANG Tao1 LI Weiping1 WANG Dayu2 　　1.Gastroenterology Department， Huzhou Central Hospital in Zhejiang Province， Huzhou 313000， China； 2.General Surgery Department， Huzhou Central Hospital in Zhejiang Province， Huzhou 313000， China 　　[Abstract] Objective To evaluate the clinical efficacy and safety of ERAT on patinents with suspected acute appendicitis. Methods A total of 32 patients with clinically acute appendicitis were randomly divided into experimental group（n=17） and control group（n=15） for different treatment methods. And control group accepted laparoscopic appendectomy. Experimental group was treated by endoscopic retrograde appendix therapy after bowel preparation. According to the specific sutiation， taking out the fecalith， implanting the appendix stent or douching the appendix cavity was choosed. Then clinical curative effect and adverse reactions between two groups were observed. Results Patients treated by ERAT all had no complications， and had no stastisties difference（P0.05） with patients treated by LA. They were also associated with low fee[（5401.07±916.69） yuan vs （8217.67±1313.02） yuan， P0.01）， faster body temperature recover[（6.81±3.89） h vs （34.21±9.78） h， P0.01）， faster leucocyte descent [（1.50±0.73） d vs （3.00±0.88）