术尔泰溶液在腹腔镜急性化脓性阑尾切除术中的应用

Application of Shuertai solution in laparoscopic appendectomy for acute suppurative appendicitis

目的探讨术尔泰在急性化脓性阑尾炎腹腔镜切除术中的应用价值。方法将196例急性化脓性阑尾炎患者随机分成两组,术中术尔泰应用组106例(观察组),未应用术尔泰组90例(对照组)。两组在腹腔镜阑尾切除后,用大量温生理盐水冲洗腹腔至清亮,吸除残液,治疗组再加用术尔泰腹腔冲洗、部分留置;脐部腹膜缝合后治疗组和对照组均以碘伏消毒处理。比较两组术后切口感染率,术后72 h后腹胀及粘连性肠梗阻二次手术发生率,术后疼痛和恶心呕吐等并发症发生率。结果治疗组106例中无切口感染,术后72 h后腹胀者4例(3.7%),术后疼痛10例(9.4%),恶心呕吐6例(5.6%),腹腔脓肿0例;对照组90例中脐部切口感染3例(3.3%),术后72 h后腹胀者16例(17.8%),疼痛46例(51.1%),恶心呕吐28例(31.1%),腹腔脓肿8例(8.8%)。结论术尔泰可以有效预防切口感染、腹腔脓肿,减少术后疼痛和恶心呕吐等并发症的发生,缩短住院时间。

Objective To investigate the value of Shuertai in laparoscopic appendectomy for acute suppurative appendicitis.Methods A total of 196 patients with acute suppurative appendicitis were assigned into two groups randomly： The observation group（106 cases with Shuertai treatment） and the control group（90 cases without use of Shuertai）.After appendectomy,the abdominal cavity of all patients was lavaged with large amount of warm saline until the returning fluid was quite clear,then the residual liquid was aspirated.The patients in observation group were then additionally lavaged with Shuiertai and a small amount of Shuieratai was retained.The umbilical incision was closed and treated with iodophor in all the patients.The postoperative complications,including rate of incisional wound infection,abdominal distention at 72 h after operation,reoperation because of adhesive ileus,postoperative pain,nausea and vomiting,between the two groups were compared.Results The rate of incisional wound infection,abdominal distention at 72 h after operation and other postoperative complications such as pain,nausea,vomiting and intra-abdominal abscess was 0%（0/106）,3.7%（4/106）,9.4%（10/106）,5.6%（6/106） and 0%（0/106） respectively in the observation group,and was 3.3%（3/90）,17.8%（16/90）,51.1%（46/90）,31.1%（28/90）,and 8.8%（8/90） in the control group,respectively.Conclusions The application of Shuertai in laparoscopic appendectomy can prevent incisional wound infection and intra-abdominal abscess,reduce postoperative pain,nausea and vomiting,and shorten the postoperative hospital stay.