腹腔镜阑尾切除术中阑尾根部不同处理方法的对比研究
Comparative Study of Different Treatment Methods of Appendix Root in Laparoscopic Appendectomy

目的：探讨腹腔镜阑尾切除术中阑尾根部结扎、阑尾根部荷包包埋、hem-o-lok夹闭三种常见的处理方式对患者的治疗效果，为腹腔镜阑尾炎患者提供个性化治疗方案。方法：回顾2022年5月~2023年5月，于北华大学附属医院普通外科，因急性阑尾炎伴或不伴有局限性腹膜炎收入我科，且行腹腔境阑尾切除术的患者为研究对象，根据术中阑尾处理方式的情况，将研究对象分为三组，阑尾根部结扎组(A组)，阑尾根荷包包埋组(B组)，hem-o-lok夹闭组(C组)，并收集三组患者临床资料(手术时间，术后镇痛药物使用率，术后患者下地活动时间，术后排气时间、术后患者有无术后并发症)比较分析。结果：三组患者共纳入156人，其中A组52人，B组56人，C组48人。三组患者术后下地活动时间，排气时间，术后镇痛药物使用，均无统计意义(P > 0.05)。术后并发症回顾分析，统计术后出现阑尾残株炎、阑尾残端瘘、腹盆腔脓肿的患者均为零，未发生上述并发症。根据数据统计分析仅在手术时间上存在差异(P < 0.05)。结论：hem-o-lok夹闭阑尾根部在手术时间上明显优于其他两组。阑尾根部的荷包包埋更有推广应用价值。
Objective: To explore the therapeutic effects of three common treatment methods in laparoscopic appendectomy, such as appendectomy root ligation, appendectomy root bag embedding and hem-o-lok clamp, in order to provide personalized treatment who have laparoscopic appendicitis. Method: The patient was admitted to the General Surgery Department of the Affiliated Hospital of Beihua University from May 2022 to May 2023 who underwent abdominal appendectomy due to acute appendicitis with or without circumstantial peritonitis were reviewed as the study subjects. Treatment of the appendix is divided into three groups: Appendix root ligation group (group A). Appendectomy root bag embedding group (group B) and hem-o-lok clamp group (group C) were compared and analyzed. Collecting clinical data (operation time, postoperative analgesic drug utilization rate, postoperative movement time, postoperative exhaust time, postoperative complications). Results: A total of 156 patients were included, embrace 52 in group A, 56 in group B, and 48 in group C. Postoperative activity time, exhaust time and postoperative analgesic drug use in the three groups were not statistically significant (P > 0.05). Retrospective analysis of postoperative complications showed that none of the patients with appendicitis, appendicitis fistula and abdominal and pelvic abscess occurred. According to the statistical analysis of the data, the operation time was different (P < 0.05). Conclusion: The operation time of hem-o-lok appendectomy was significantly better than that of the other two groups. The pouch embedding process at the root of the appendix is more valuable to popularize and apply.