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介绍32例小儿阑尾炎行腹腔镜阑尾切除术(Laparoscopic Appendectomy,LA)的操作方法及适应证的选择,并评价其优越性。本组年龄7～14岁。单纯性、化脓性、坏疽性阑尾分别为10例,16例,6例,其中异位阑尾3例,误诊2例,均采用椎管麻醉,低压气腹完成腹腔镜手术。31例完成腹腔镜手术,1例为腹膜后阑尾炎中转开腹手术。误诊2例均通过腹腔镜得到诊断同时做了相应治疗,32例均痊愈出院。腹腔镜手术具有创伤小、痛苦轻、手术时间短、术后恢复快、并发症少等优点。对诊断不十分明确的病例,选择腹腔镜探查可降低误诊、误治。严格掌握适应证,正确把握中转手术时机是减少并发症的关键。
To introduce the operation method and indications of laparoscopic appendectomy (LA) in 32 children with appendicitis and to evaluate its superiority. The age of 7 to 14 years old. Simple, purulent, gangrenous appendix were 10 cases, 16 cases, 6 cases, including 3 cases of heterotopic appendix, misdiagnosed 2 cases, were used spinal anesthesia, low pressure pneumoperitoneum laparoscopic surgery. 31 cases completed laparoscopic surgery, 1 case of retroperitoneal appendicitis transit laparotomy. Two cases of misdiagnosis were diagnosed by laparoscopy at the same time made the appropriate treatment, 32 patients were discharged. Laparoscopic surgery has the advantages of less trauma, less pain, shorter operation time, faster postoperative recovery and less complications. The diagnosis is not very clear cases, choose laparoscopic exploration can reduce the misdiagnosis, mistreatment. Strict control of indications, to correctly grasp the timing of transit surgery is the key to reducing complications.