腹腔镜治疗小儿阑尾炎156例临床的的体会.docVIP

腹腔镜治疗小儿阑尾炎156例临床的的体会 　　摘要：目的 探讨小儿阑尾炎腹腔镜手术[1]术式的选择及相应的适应症。方法 应用小儿腹腔镜对156例小儿阑尾炎分别行双孔法、三孔法及采用带操作孔道腹腔镜的脐部单孔法手术[2]治疗。所有病例均行气管内插管麻醉，造成人工气腹，使用电视腹腔镜，以内凝或电凝及套扎方法完成阑尾切除术。结果 无中转开腹手术[3],均在腹腔镜下完成手术,术中出血平均3ml，且多为脐部切口出血。手术时间20~60min,平均30min。其中腹腔包裹积液1例，脐部切口感染2例,住院时间3~7d,平均5d。随访1~24个月,其余病例均恢复良好。结论 小儿腹腔镜治疗小儿阑尾炎具有时间短、出血少、创伤小、并发症少、术后恢复快等优点,适合推广。适当选择腹腔镜手术的具体方法可发挥其优势,取得更好的临床效果。 　　关键词：小儿；阑尾炎；腹腔镜；阑尾切除术；适应证 　　Laparoscopic Treatment of Pediatric Appendicitis 156 Cases of Clinical Experience 　　YANG Wei,JIN Dan 　　(Fushun City Mining Bureau General Hospital,Fushun 113008,Liaoning ,China) 　　Abstract：ObjectiveTo explore pediatric appendicitis laparoscopic surgery ［1］, the selection of operative.MethodsPediatric laparoscopic method application in 156 cases of pediatric appendicitis were separately double hole method, three hole method and used for channel operation laparoscopic surgery the bellybutton puckering method ［2］. All cases were performed tracheal intubation anesthesia, artificial pneumoperitoneum, using television laparoscopic coagulation or within electric coagulation and complete appendectomy TaoZa method. Results No transfer laparotomy were completed in laparoscopic surgery［3］, intraoperative bleeding average 3 ml, and navel incision bleeding. Operation time of 20 ~ 60 minutes, 30 minutes on average. Including abdominal package effusion, navel incision infection in 2 cases, hospitalization time 3 ~ 7 days, 5 days on average. Were followed up for 1 ~ 24 months, the remaining cases were recovered well. ConclusionPediatric laparoscopic treatment of pediatric appendicitis has shorter time, less bleeding, small trauma, fewer complications, faster postoperative recovery, etc, suitable for promotion. Choose appropriate methods to laparoscopic surgery can exert its advantages, achieve better clinical effect. 　　Key words：Children; Appendicitis; Laparoscope; Appendectomy; Indications 　　2011年1月～2012年12月，我院选择性地对156例小儿阑尾炎行腹腔镜阑尾切除术，效果满意，总结如下。 　　1资料与方法 　　1.1一般资料本组156例中男88例，女68例，年龄3～14岁，平均