延迟阑尾炎切除术治疗急性非穿孔性阑尾炎的可行性分析

The analysis of delayed appendectomy in the treatment of patients with acute nonperforated appendicitis

目的本研究旨在探讨延迟阑尾炎切除术治疗急性非穿孔性阑尾炎的安全性和可行性。方法收集2004年1月至2013年2月期间在北林区第一人民医院普外科确诊为急性非穿孔性阑尾炎的患者902例,所有患者均接受了阑尾切除术。根据手术时间的不同,将患者分为两组:急诊手术组(入院后24小时内接受手术治疗)和延迟手术组(入院后24~48小时接受手术治疗)。观察指标包括手术时间、术中阑尾穿孔率、术后并发症发生率、二次住院比率、住院时间。结果在902例患者中,671例患者(74.3%)在住院24小时内立即接受了急诊手术治疗,而另外231例患者(25.7%)在入院后24~48小时期间进行了延迟手术治疗。两组病例在手术时间,术中阑尾穿孔比例,术后并发症发生率,以及再入院比例方面差异无统计学意义。然而,与急诊手术相比,延迟手术组患者的住院时间要明显高于急诊手术组患者(t=7.34;P=0.02)。结论对于急性非穿孔性阑尾炎患者,延迟阑尾切除术也是一个安全合理的选择。

Objective We aimed to evaluate the safety and feasibility of delayed appendectomy in the treatment of acute, nonperforated appendicitis. Methods We collected the patients who underwent an appendectomy for acute, nonperforated appendicitis between January 2004 and February 2013 in the First People′s Hospital of North Forest Region. Patients were divided into 2 groups for comparison： an immediate group（those who were moved to an operating room within 24 hours after hospital arrival） and a delayed group（those within 24 to 48 hours after hospital arrival）. The end points were operative time, perforation rate, complication rate, readmission rate and length of hospital stay. Results Of 902 patients, 671（74.3%） underwent immediate operation within 24 hours after hospital arrival, whereas 231（25.7%） underwent delayed operation within 24 to 48 hours. There were no significant differences in operative time, perforation, postoperative complications, and readmission between the 2 groups. Length of hospital stay was significantly greater was also greater in the delayed group than in the immediate group（t=7.34; P=0.02）. ConclusionDelayed appendectomy is safe for patients with acute nonperforated appendicitis.