远航条件下44例阑尾切除术的临床分析

Clinical analysis of 44 cases of appendectomy under prolonged deployment at sea

目的 探讨远航条件下实施阑尾切除术的临床疗效和时机选择.方法 对2000年4月至2015年8月解放军第四一三医院医疗队远洋航行中实施的44例阑尾切除术患者进行回顾性分析,根据手术距发病时间长短患者被分为2组：早期手术组在发病48 h内接受手术,延期手术组在发病48 h后接受手术.观察并分析2组患者的手术相关资料、术后恢复情况和并发症发生情况.结果 2组间术中出血量、因病离岗时间和并发症发生率比较,差异有统计学意义[（21.5 ±5.7）ml vs.（28.1±7.8） ml,（6.5 ±1.2）d vs.（9.2±3.4）d,（0） vs.（15％）,t=3.15,t=3.38,x2 =3.86,P＜0.05],手术时间、肛门恢复排气时间比较,差异无统计学意义[（31.9±5.3）min vs.（34.1±9.8）min,（17.5 ±3.2）h vs.（19.5±3.4）h,t=0.90,t=2.00,P＞0.05].结论 远航中阑尾切除临床疗效满意,如阑尾炎患者经保守治疗症状无改善应在发病48 h内实施阑尾切除手术.

Objective To investigate the therapeutic efficacy and choice of opportune time for appendectomy during prolonged deployment at sea.Methods Retrospective analysis was made on the 44 cases of appendectomy performed by the medical teams of No.413 hospital,from April 2000 to August 2015,during prolonged deployment at sea.The patients were divided into 2 groups.The patients in the early surgical group received surgery within 48 hours of onset,and those in the delayed surgical group had surgery 48 hours after onset.Surgery-related medical data,recovery after surgery and the incidence of complications were closely observed and analyzed.Results There were significant differences in intra-surgical hemorrhage,days of absence from combat posts due to diseases and incidence of complications between the 2 groups [（21.5 ± 5.7） mlvs.（28.1±7.8） ml,（6.5±1.2） dvs.（9.2±3.4） d,0 vs.15%,t=3.15,t=3.38,x2=3.86] （P 〈 0.05）.However,no significant differences could be seen in surgical time and recovery of exsufflationtime [（31.9±5.3） minvs.（34.1±9.8） min,（17.5 ±3.2） h vs.（19.5 ±3.4） h,t=0.90,t =2.00] （P 〈 0.05）.Conclusions The therapeutic efficacy of appendectomy during prolonged deployment at sea was on the whole satisfactory.If symptoms of patients were not improved following conservative treatment,appendectomy should be performed within 48 hours after onset.