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  [摘要] 目的：对比阑尾炎不同手术方法术后的观察及护理。方法：选择165例阑尾炎患者并分为两组：腹腔镜下阑尾切除术组(微创组)87例，传统阑尾切除术组(传统组)78例，采用对照研究方法，用数字式评估工具对165例患者的术后情况及护理进行对比。结果：两组患者的切口疼痛程度、胃肠功能恢复时间、术后并发症和住院天数比较，差异有显著性(P0.05)。结论：微创组患者痛苦小、术后恢复快、并发症少，且腹壁美观，护理相对简单，节省人力，明显优于传统组。

 [关键词] 阑尾炎；腹腔镜；护理

 [中图分类号] R574.61[文献标识码]A [文章编号]1673-7210(2009)05(a)-014-02

 Comparative observation and nursing between minimally invasive and traditional appendectomy

 SHEN Lixia

 (Maternal and Child Health Hospital of Linyi City, Shandong Province, Linyi 276000, China)

 [Abstract] Objective: To compare the observation and nursing of appendicitis after operated on in different surgical ways. Methods: 165 cases of patients with appendicitis were selected and divided into two groups: laparoscopic appendectomy group (minimally invasive group), 87 cases; and traditional appendectomy group (traditional group), 78 cases. Control study methods and digital assessment tools were applied to compare 165 patients' situation and nursing after operation. Results: The degree of surgical incision pain, gastrointestinal function recovery time, postoperative complications and the days of hospital stay of two groups showed significant differences (P0.05). Conclusion: Patients in minimally invasive group have little pain, rapid recovery after operation, fewer complications and beautiful abdominal wall compared with traditional group. Their nursing is relatively simple, and could save labor, so it is much better than traditional group.

 [Key words] Appendicitis; Laparoscope; Nursing

 我院2006年2月～2008年3月共收治阑尾炎患者165例，其中,腹腔镜下阑尾切除术(laparocopic appendectomy, LA)组(微创组)87例，采用传统阑尾切除术(传统组)78例，对两种手术方法进行比较，现总结如下：

 1 资料与方法

 1.1 一般资料

 我院2006年2月～2008年3月共收治阑尾炎患者165例，男102例，女63例，年龄4～75岁，平均16.8岁。急性单纯性阑尾炎50例，急性化脓性阑尾炎72例，急性坏疽性阑尾炎30例，慢性阑尾炎13例。其中，合并胆囊炎并胆结石2例，合并腹股沟斜疝1例，合并卵巢囊肿蒂扭转1例，合并子宫内膜异位症1例，有合并症者均采用腹腔镜联合手术。所有病例均经病理证实为阑尾炎。微创组阑尾炎分类：急性单纯性阑尾炎35例，急性化脓性阑尾炎32例，急性坏疽性阑尾炎12例，慢性阑尾炎8例；传统组阑尾炎分类：急性单纯性阑尾炎17例，急性化脓性阑尾炎33例，急性坏疽性阑尾炎22例，慢性阑尾炎6例。

 1.2 方法

 从患者术毕回病房到患者出院，通过医护人员治疗及护理过程中的客观观察、与患者的交谈、有意识的询问及查阅辅助检查报告单，根据患者的症状、体征、住院天数、住院费用将资料汇总，进行分析比较。

 1.3 观察指标

 两组患者切口疼痛程度、胃肠功能的恢复时间、术后并发症、住院天数、住院费用。

 1.4 统计学方法

 应用SPSS 10.0软件包，采用Kruska-wallis秩和检验分析 ......