Abstract: 【Abstract】〓Objective〓To evaluate the effect of peritoneal lavage on laparoscopic appendectomy in patients with purulent peritonitis. Methods〓130 cases of acute appendicitis with purulent peritonitis from 2010 to 2014 were selected and divided into two groups based on surgical approaches..The patients in the observation group(n=64) were treated with peritoneal lavage during laparoscopic appendectomy and those in the control group were performed laparoscopic appendectomy alone(n=66)..The postoperative anal exhaust time, hospital stay, hospitalization expense, operative time, leucocyte count in 24 and 72 hours after operation, the complications were compared between the two groups. Results All the operation was successfully performed..Compared with the control group,.the observation group showed shorter postoperative anal exhaust time and hospital stay,.less hospitalization expense,.lower leucocyte count after operation 24 and 72 hours.(27.29±4.29 h vs 36.75±5.93 h,.4.83±1.18 d vs 6.34±1.34 d,7090±807 yuan vs 8880±1304 yuan,9.20±1.20×109/L vs 12.78±1.20×109/L,5.51±1.15×109/L vs 8.94±0.92×109/L),.and there was statistical difference. Meanwhile, the complications in the observation group were significantly less than in the control group..However,.peritoneal lavage spent longer operative time(51.29±6.32 min vs 41.16±2.95 min,.P<0.05). Conclusion〓The effect of peritoneal lavage during laparoscopic appendectomy is safe and effective in the treatment of acute appendicitis with purulent peritonitis..Although long time of operation,.it possesses advantages of short time of hospitalization period,.less hospitalization expense and complications.

Key words: Appendicitis, Laparoscopy, Peritonitis, Peritoneal lavage

摘要： 【摘要】 目的 探讨腹腔冲洗在腹腔镜手术治疗急性阑尾炎伴化脓性腹膜炎中的作用。方法〓2010年至2014年我院收治的急性阑尾炎伴化脓性腹膜炎并接受腹腔镜手术治疗的病例,随机分两组:腹腔镜下阑尾切除后腹腔冲洗组(观察组)64例,腹腔镜下阑尾切除后非冲洗组(对照组)66例。比较两组术后肛门排气时间、住院时间、住院费用、手术时间、术后24、72小时外周血白细胞计数及术后并发症发生率。结果〓本研究组所有病例均在腹腔镜下完成手术,无中转剖腹手术。观察组术后肛门排气时间、住院时间、住院费用、术后24、72 h外周血白细胞计数明显少于对照组27.29±4.29 h比36.75±5.93 h、4.83±1.18 d比6.34±1.34 d、7090±807元比8880±1304元、9.20±1.20×109/L比12.78±1.20×109/L、5.51±1.15×109/L比8.94±0.92×109/L,差异有统计学意义。观察组并发症发生率明显低于对照组1.56%比15.15%,差异有统计学意义。但观察组的手术时间较对照组有所延长51.29±6.32 min比41.16±2.95 min,差异有统计学意义。结论〓腹腔冲洗在腹腔镜手术治疗急性阑尾炎伴化脓性腹膜炎安全、有效,患者恢复快,术后并发症少,但手术时间有所延长。

关键词: 阑尾炎, 腹腔镜, 腹膜炎, 腹腔冲洗