手术时机对急性阑尾炎预后影响研究

Influence of operation opportunity on the prognosis of acute appendicitis

目的研究不同手术时机对急性阑尾炎预后的影响。方法回顾性分析中国医科大学附属第四医院2014年1月至2016年5月428例急性阑尾炎病人临床资料。根据病人手术时机的不同,将发病≤72 h行手术治疗的328例病人纳入72 h内手术组,发病时间>72 h行手术治疗的100例病人纳入延迟手术组,分析不同的手术时机与病人住院时间、手术时间、手术费用、排气时间、中转开腹率、术后并发症发生情况间的关系。结果延迟手术组住院费用高于72 h内手术组(P<0.05),而两组病人手术时间、住院时间、排气时间、中转开腹率以及术后并发症发生情况差异无统计学意义。结论急性阑尾炎发病时间>72 h的病人同样可行手术治疗,且可行腹腔镜阑尾切除术,避免二次入院手术治疗,缩短病程,减少住院费用,减轻病人痛苦。

Objective To investigate the effect of different operation time on the prognosis of patients with acute appendicitis. Methods The clinical data of 428 patients admitted between January 2014 and May 2016 in the Fourth Affiliated Hospital of China Medical University were analyzed retrospectively. A total of 328 patients with the onset of the disease within 72 h was brought into the 72 h surgery group, while 100 patients were brought into the delayed surgery group after 72 h, The relationship between the different operation opportunity and the time of hospitalization, the time of operation, the cost of operation, the exhaust time, the rate of conversion to open surgery, the incidence of postoperative complications were analyzed. Results The cost of hospitalization in the delayed surgery group was higher than that in the 72 h surgery group, but the operation time, hospitalization time, exhaust time, conversion to open surgery rate and postoperative complications were not different significantly. Conclusion For patients with onset time more than 72h, the primary operation treatment including laparoscopic appendectomy is also feasible, so as to avoid the second admission surgery, shorten the length of hospitalization, reduce the cost, and reduce the pain of patients.