目的总结腹腔镜阑尾切除术(laparoscopic appendectomy，LA)的应用经验。方法回顾性分析我院2009年5月至2010年8月期间153例行LA手术患者的临床资料。结果153例中男74例，女79例; 年龄8～76岁，平均32.5岁。其中慢性阑尾炎7例，急性单纯性阑尾炎41例，急性化脓性阑尾炎81例，急性坏疽穿孔性阑尾炎24例。149例在腹腔镜下顺利完成手术，4例因阑尾周围组织水肿及粘连明显、镜下解剖不清而中转开腹。手术时间30～90 min，平均51 min。住院时间3～8 d，平均5 d。发生脐部戳孔感染5例。随访1～12个月（平均5个月），无术后出血、腹腔脓肿及粘连性肠梗阻发生。结论LA创伤小，疤痕小，恢复快，住院时间短，并发症少，安全性高。
目的探讨在腹腔镜阑尾切除术（laparoscopic appendectomy，LA）中应用Lapro-Clip可吸收生物夹的优势。 方法回顾性分析2011年7月至2013年4月期间于秦皇岛市抚宁县人民医院微创外科施行LA术的294例阑尾炎患者的临床资料，对其效果进行分析和评价。 结果294例阑尾炎患者行LA术时，均采用Lapro-Clip可吸收生物夹（12 mm）处理阑尾及其系膜。所有患者术中出血均＜10 mL，手术时间13～48 min（平均24 min），住院时间为2～7 d（平均4 d）。术后均无切口感染、肠瘘、腹腔出血、粘连性肠梗阻等并发症发生。术后以电话随访294例，随访时间为3～12个月，平均6个月，均无腹胀、腹痛等并发症发生。 结论LA术中应用Lapro-Clip可吸收生物夹处理阑尾根部及其系膜的操作简单、安全，能节省手术时间。
目的 探讨隐蔽三孔法腹腔镜阑尾切除术的应用。方法 患者取头低左侧卧位。在脐缘切口插入10 mm的套管，放入腹腔镜。在腹腔镜监视下分别于耻骨结节左、右侧阴毛生长区作10 mm、5 mm切口，两切口相距8~10 cm。术者通过耻骨上途径完成阑尾切除操作。结果 192例痊愈出院，无一例手术中转，平均手术时间（25±4.32） min，平均住院时间（5±0.79） d。切口甲级愈合，基本不留疤痕。无手术并发症发生。结论 隐蔽三孔法腹腔镜阑尾切除术具有美容效果好、创伤小、并发症少等优点。
目的 探讨三孔法腹腔镜胆囊阑尾联合切除术的临床价值。 方法 对64例胆囊良性病变合并急、慢性阑尾炎患者实施三孔法胆囊阑尾腹腔镜联合切除的临床资料进行分析。结果 64例均获成功，手术时间40~80 min，术后3~5 d出院，无并发症发生。结论 三孔法腹腔镜胆囊阑尾联合切除术具有创伤小、痛苦少、恢复快、住院时间短等优点，治疗胆囊阑尾良性疾病安全可靠，并可有效降低医疗费用。
目的:分析X线对小儿穿孔性阑尾炎的诊断价值。方法:对经临床手术证实为穿孔性阑尾炎50例的腹部X线平片资料（含12例B超、7例CT资料）作回顾性分析。结果:X线表现为右侧胁腹脂线短缩及腹脂线髂段模糊41例，横结肠充气征43例，小肠积气（小肠环内径≤3 cm）12例、胀气（小肠环内径gt;3 cm）38例，小肠积液50例，小肠壁增厚32例，回盲部密度增高并小气泡影12例，右侧腹腔少量游离气体1例。结论:X线检查对穿孔性阑尾炎有一定诊断价值，结合超声检查和/或CT检查可提高诊断准确率。
目的 探讨急性阑尾炎手术后切口感染的相关因素。方法 观察我院2002年5月至2007年5月期间收治的665例急性阑尾炎患者采用术前预防使用抗生素、术中保护切口、术后加强切口管理等处理后切口感染情况，并分析切口感染与阑尾炎的病程、手术时间、切口选择、留置引流和病理类型之间的关系。结果 本组患者中32例发生切口感染，感染率为4.81% (32/665)，急性阑尾炎术后切口感染与性别无关（ P ＞ 0.05），与病程长短、切口选择、手术时间、腹腔留置引流与否以及病理类型均有关（ P ＜ 0.01）。结论 病程长、手术时间久、炎症较重的急性阑尾炎病例切口感染率较高； 做好围手术期的处理，术中尽量保护切口可以降低切口感染率。
ObjectiveTo investigate the efficacy and safety of laparoscopic surgery for overweight/obese patients with acute perforated or gangrenous appendicitis. MethodsFrom January 2007 to December 2014, patients with acute perforated or gangrenous appendicitis underwent laparoscopic (152 cases) or open (60 cases) appendectomy were collected, who were retrospectively classified into overweight/obese group (BMI≥25 kg/m2, n=69) or normal weight group (BMI < 25 kg/m2, n=143). Conversion rate, operation time, hospital stay, readmission, reoperation, and postoperative complications such as incision infection, abdominal abscess, and lung infection were analyzed. Results①The rate of conversion to open surgery had no significant difference between the overweight/obese group and the normal weight group[4.2% (2/48) versus 6.7% (7/104), χ2=0.06, P > 0.05].②The operation time of laparoscopic surgery in the overweight/obese group was significantly shorter than that of the open surgery in the overweight/obese group[(41.6±11.7) min versus (63.1±23.3) min, P < 0.01], which had no significant difference between the laparoscopic surgery in the overweight/obese group and laparoscopic surgery in the normal weight group[(41.6±11.7) min versus (39.6±12.7) min, P > 0.05].③The total complications rate and incision infection rate of the laparoscopic surgery in the overweight/obese group were significantly lower than those of the open surgery in the overweight/obese group[total complications rate:16.7% (8/48) versus 52.4% (11/21), χ2=9.34, P < 0.01; incision infection rate:4.2% (2/48) versus 33.3% (7/21), χ2=8.54, P < 0.01]. Although the total complications rate of all the patients in the overweight/obese group was increased as compared with all the patients in the normal weight group[27.5% (19/69) versus 14.7% (21/143), χ2=5.02, P < 0.01], but which had no significant difference between the laparoscopic surgery in the overweight/obese group and laparoscopic surgery in the normal weight group[16.7% (8/48) versus 12.5% (13/104), χ2=0.45, P > 0.05].④The reoperation rate of all the patients performed laparoscopic surgery was significantly lower than that of all the patients performed open operation[1.3% (2/152) versus 10.0% (6/60), χ2=6.7, P < 0.01].⑤The abdominal abscess rate, lung infection rate, and hospital stay after discharge had no significant differences among all the patients (P > 0.05). ConclusionLaparoscopic appendectomy could be considered a safe technique for overweight/obese patients with acute perforated or gangrenous appendicitis, which could not increase the difficulty of laparoscopic surgery and the perioperative risk.