不同手术时机在老年性急性阑尾炎延迟手术及急诊手术中的应用

Application of different surgical time in delayed surgery and emergency surgery of senile acute appendicitis

目的探讨不同手术时机在老年性急性阑尾炎(AA)延迟手术及急诊手术中的应用。方法回顾性分析2017年6月~2018年5月我院收治的103例老年性AA患者的临床资料,跟据手术时机的不同将其分为对照组(50例)和观察组(53例)。将病程>72 h行腹腔镜阑尾切除术(LA)治疗的患者作为对照组,将病程≤72 h行LA手术治疗的患者作为观察组。比较两组的临床指标、中转开腹率及并发症总发生率。结果观察组的手术时间、排气时间、住院时间及抗生素使用时间短于对照组,术中出血量和住院费用少于对照组,差异均有统计学意义(P<0.05);两组的中转开腹率比较,差异无统计学意义(P>0.05);观察组的并发症总发生率为5.66%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论老年性AA患者发病≤72 h接受手术治疗能缩短手术时间、排气时间、住院时间及抗生素使用时间,减少术中出血量和住院费用,降低并发症总发生率。

Objective To explore the application of different surgical time in delayed surgery and emergency surgery of senile acute appendicitis(AA).Methods The clinical data of 103 elderly AA patients admitted to our hospital from June 2017 to May 2018 were analyzed retrospectively,they were divided into control group(50 cases)and observation group(53 cases)according to the time of operation.The patients who had laparoscopic appendectomy(LA)for more than 72 hours were selected as the control group,and the patients who had LA for less than or equal to 72 hours as the observation group.The clinical indexes,conversion rate to laparotomy and the total incidence of complications were compared between the two groups.Results The operation time,exhaust time,hospitalization time and antibiotic use time of the observation group were shorter than those of the control group,and the amount of bleeding and hospitalization cost were less than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the conversion to open rate between the two groups(P>0.05).The total incidence of complications in the observation group was 5.66%,lower than that in the control group(20.00%),the difference was statistically significant(P<0.05).Conclusion The elderly patients with AA less than or equal to 72 hours can shorten the operation time,exhaust time,hospitalization time and antibiotic use time,reduce intraoperative bleeding and hospitalization cost,and reduce the total incidence of complications.