经麦氏切口双氧水腹腔冲洗治疗急性化脓性坏疽性阑尾炎112例的疗效分析

Peritoneal lavage with hydrogen peroxide by McBurney incision in the treatment of patients with acute purulent gangrenous appendicitis:report of 112 cases

目的探讨经麦氏切口双氧水腹腔冲洗治疗急性化脓性、坏疽性阑尾炎的疗效。方法对112例急性化脓性、坏疽性阑尾炎取麦氏切口入腹,将手术床分别向下及向右各倾斜15°～30°,用卵圆钳将腹腔引流管置入盆腔、左中腹腔及右侧肝肾隐窝,用1.5%双氧水(3%双氧水原液中加入等量生理盐水)从引流管注入进行腹腔冲洗,观察其疗效。结果全组病例平均住院8 d,切口感染2例,切口液化1例,均无腹腔残余脓肿、门脉感染、脓毒血症及膈肌刺激症状等,无死亡病例。结论经麦氏小切口双氧水腹腔冲洗治疗急性化脓性、坏疽性阑尾炎疗效肯定,手术损伤小,患者痛苦小,值得临床推广应用。

Objective To observe the effects of peritoneal lavage with hydrogen peroxide by McBurney incision in treatment of patients with acute purulent gangrenous appendieitis. Methods One hundred and twelve patients with acute purulent, gangrenous appendicitis underwent the operation by McBurney incision. The operating table was tilted 15 to 30 degrees, and to the right down respectively, with the oval clamp the abdominal drainage tube was placed in the pelvic cavity, left middle position of abdominal cavity and the left right side recess of the liver and kidney,then 1.5% hydrogen peroxide （3% hydrogen peroxide stock solution was diluted with equivalent volume of saline） was infused from the drainage tube into abdominal savity for the peritoneal lavage,and the efficacy was evaluated. Results The average hospital stay was 8 days, wound infection was found in 2 eases, wound liquefaction in 1 case, no abdominal residual abscess, portal vein infection, sepsis and diaphragm stimulation symptoms were found. No dead case was found. Conclusion The effect of peritoneal lavage with hydrogen peroxide by McBumey incision in the treatment of patients with acute purulent, ganrenous appendicitis is effeetive. This method has advantages such less damage, little oain. and is worthy of clinical aoolication.