【摘要】 目的比较、分析不同类型急性盲肠憩室炎的治疗过程,探讨最优治疗方案。方法回顾性分析辽宁省健康产业集团抚矿总医院2012年7月～2017年7月收治的60例急性盲肠憩室炎住院患者的临床资料,经保守治疗或手术治疗(腹腔镜或开腹手术)后,观察病情转归、住院时间、复发腹痛率及复发再住院率。对比、分析保守组与手术组、腹腔镜手术亚组与开腹手术亚组之间的差异。结果急性单纯性盲肠憩室炎:保守组的住院时间明显短于手术组,差异有统计学意义(P<0.01);两组的复发腹痛率及复发再住院率比较,差异均无统计学意义(P>0.05)。急性复杂性盲肠憩室炎:手术组的住院时间明显短于保守组,复发腹痛率、复发再住院率及腹腔脓肿率均明显低于保守组,差异有统计学意义(P<0.01)。腹腔镜手术亚组的住院时间、术后排气时间均短于开腹手术亚组,术中出血量少于开腹手术亚组,术后第1、3天的疼痛评分均低于开腹手术亚组,差异有统计学意义(P<0.05);两亚组的切口感染、术后消化道瘘发生率比较,差异无统计学意义(P>0.05)。结论急性单纯性盲肠憩室炎应首先行抗生素保守治疗;急性复杂性盲肠憩室炎则应首选急诊手术治疗,腹腔镜手术治疗急性盲肠憩室炎安全有效,临床上值得进一步推广。更多还原

【Abstract】 Objective To compare and analyze the treatment process of different types of acute cecal diverticulitis, and to explore the optimal therapeutic regimen. Methods The clinical data of 60 patients with acute cecal diverticulitis treated in Fukuang General Hospital, Liaoning Health Industry Group from July 2012 to July 2017 were retrospectively analyzed. After conservative or surgical treatment(laparoscopy or laparotomy), the outcome of the disease, hospital stay,recurrent abdominal pain rate and re-hospitalization rate were observed. The differences between the conservative and surgical groups, the laparoscopic surgery subgroup, and the laparotomy subgroup were analyzed. Results In acute simple cecal diverticulitis, the hospital stay in the conservative group was significantly shorter than that in the surgical treatment group, with statistical significance(P<0.01). There were no significant differences in the recurrence rates of abdominal pain and re-hospitalization between the two groups(P>0.05). In acute complicated cecaldiverticulitis, the hospital stay of the surgical treatment group was significantly shorter than that of the conservative group, the recurrent rates of abdominal pain and re-hospitalization, and abdominal abscess rate were significantly lower than those in the conservative group, and the differences were statistically significant(P<0.01). The hospital stay and postoperative exhaustion time in the laparoscopic surgery subgroup were shorter than those in the laparotomy subgroup, the intraoperative blood loss was less than that in the laparotomy subgroup, and the pain scores of the first and third days were lower than those in the laparotomy subgroup, with statistical differences(P<0.05). There were no significant differences in the incidence of incision infection and postoperative gastrointestinal fistula between the two subgroups(P>0.05). Conclusion Acute simple cecal diverticulitis should be treated with antibiotics firstly. Acute complicated cecal diverticulitis should be treated with emergency surgery. Laparoscopic surgery is safe and effective for acute cecal diverticulitis,which is worthy of further promotion.更多还原