原发性慢性阑尾炎的临床特征和手术预后的研究

Clinical characteristics and operative prognosis in patients with primary chronic appendicitis

目的分析原发性慢性阑尾炎(PCA)的临床特征和影响手术效果的相关因素。方法回顾性分析78例PCA的临床资料,按病程分为<12月、12~36月和>36月三组,分析三组术前B超、术中情况、手术用时、胃肠功能恢复时间、术后并发症发生率和术后住院时间的差异。结果三组术前B超影像表现的类型构成比不同,<12月组与>36月组比较,差异显著(P=0.031),0~36月组与>36月组相比,差异有统计学意义(P=0.046);病程越长阑尾粘连程度越重,其中<12月组与>36月组、0~36月组与>36月组相比,差异有统计学意义(P<0.05);三组的手术时间、胃肠功能恢复时间、术后并发症发生率、住院时间差异显著(P<0.05)。结论 PCA好发于中年人,病程越长,病理改变越严重,应尽早进行手术治疗。

Objective To analyze the characteristics and influence factors of surgery effect on primary chronic appendicitis （PCA）. Methods The clinical date of 78 patients with PCA were retrospectively analyzed. The patients were divided into three groups according to the course of diseases （〈12 months group, 12-36 months group and 〉36 months group）. The differences in B -ultrasound before surgery, intraoperative conditions, surgery time, gastrointestinal function recovery time, postoperative complications and hospital stay among the three groups were analyzed. Results Preoperative B-ultrasound showed that the composition of the three groups of images were different, the difference was statistically significant between 〈12 months group and 〉 36 months group （P=0.031）, and the difference was also statistically significant between 0-36 months group and 〉36 months group （P=0.046）. The longer the course of disease, the greater degree of appendix adhesion, the differences between 〈12 months group and 〉36 months group, 0-36 months group and 〉36 months group were significant （P〈0.05）. There were statistically significant differences in the operative time, gastrointestinal function recovery time, postoperative complication rate and hospitalization time among the three groups （P〈0.05）. Conclusion PCA occurs mainly in middle -aged patients, the longer the disease courseis, the worse of the pathological changes, and the surgical treatment should be taken as soon as possible.