坏疽或穿孔型阑尾炎手术患者腹腔引流预防切口感染的效果观察

Effect of abdominal drainage on prevention of incision infection in patients undergoing gangrenous or perforated appendicitis surgery

目的观察坏疽或穿孔型阑尾炎手术患者腹腔引流预防切口感染的效果,探讨腹腔引流在坏疽或穿孔型阑尾炎手术治疗中的应用价值。方法将100例坏疽或穿孔型阑尾炎患者随机分为观察组和对照组各50例,均行阑尾切除治疗,观察组行腹腔引流,对照组不予腹腔引流,对比观察术后两组并发症发生情况。结果两组均手术顺利,成功切除阑尾;观察组手术时间为(37.1±10.2)min、术中出血量为(50.2±11.2)ml,对照组为(37.4±11.3)min、(49.2±10.9)ml,两组手术时间、术中出血量比较,差异无统计学意义;观察组术后住院时间为(10.2±2.2)d、对照组为(14.2±3.4)d,两组比较差异有统计学意义(P<0.05);观察组出现切口感染1例、对照组4例,两组比较差异有统计学意义(P<0.05);观察组出现肠瘘1例、对照组0例,两组比较差异无统计学意义;两组均未发生盆腔脓肿、腹腔内出血、阑尾残株炎、盲肠壁脓肿、肠梗阻、门静脉炎、肝脓肿等严重并发症。结论坏疽或穿孔型阑尾炎手术患者实施腹腔引流,可显著减少切口感染的发生率。

OBJECTIVE To observe the effect of abdominal drainage on prevention of incision infections in the patients who underwent gangrenous or perforated appendicitis surgery and explore the value of abdominal drainage in the gangrenous or perforated appendicitis surgery. METHODS A total of 100 cases of gangrenous or perforated appendicitis patients were randomly divided into the observation group and the control group with 50 cases in each, all the patients were treated by appendectomy, the observation group underwent peritoneal drainage, while the control group did not. The incidence of complications after the surgery was compared. RESULTS Both of the two groups completed the surgery with the successful removal of the appendix. The operation duration was （37.1±10.2） min in the observation group, （37.4±11.3） min in the control group. The intraoperative blood loss was （50.2±11. 2） ml in the observation group, （49. 2±10. 9） ml in the control group, the differences in the operation duration and the intraoperative blood loss between the two groups were not statistically significant. The postoperative hospital stay was （10.2 ±2.2） days in the observation group, （14.2±3.4） days in the control group, the difference was statistically significant （P〈0. 05）. There were 1 case with incision infection in the observation group and 4 cases in the control group, the difference was statistically significant （P〈0. 05）. There were 1 case with intestinal fistula in the observation group and no case in the control group,the difference was not statistically significant. There were no cases with pelvic abscess, intra-abdominal hemorrhage, the appendix stump inflammation, cecal wall abscess, intestinal obstruction, portal vein thrombosis, liver abscesses or o,ther serious complications in neither of the two groups. CONCLUSION The abdominal drainage can significantly reduce the incidence of incision infections in the patients undergoing gangrenous or perforated appendicitis surgery.