发病时间大于72小时的急性阑尾炎腹腔镜手术疗效分析

Laparoscopic surgery for acute appendicitis with an onset time more than 72 hours

目的探讨对发病时间>72 h的急性阑尾炎行腹腔镜阑尾切除术治疗的安全性及疗效。方法回顾性分析鞍钢集团总医院2013年1月至2019年10月腹腔镜手术治疗急性阑尾炎675例临床资料,根据发病的时间差异,分为>72 h组158例和≤72 h组517例,比较两组患者的病理特征、应用抗生素比例、手术情况和术后并发症发生情况。结果两组病理类型差异有统计学意义(χ~2=23.690,P=0.002),术后均无严重并发症发生。与≤72 h组相比,>72 h组入院前抗生素使用比例更高(94.30%vs 82.21%,χ~2=10.361,P=0.037),手术时间更长(t=3.998,P=0.029),术中出血量更多(t=2.368,P=0.035)。结论对于发病时间>72 h的急性阑尾炎患者行腹腔镜阑尾切除术安全可行,可以避免二次住院手术治疗,缩短病程,减少住院费用和患者痛苦。

Objective To explore the safety and efficacy of laparoscopic appendectomy for acute appendicitis with an onset time>72 hours.Methods The clinical data of 675 cases with acute appendicitis treated by laparoscopic surgery from January 2013 to October 2019 in Angang Group General Hospital were retrospectively analyzed.According to the onset time,they were divided into 158 cases in the>72 h group and 517 cases in the≤72 h group.The pathological characteristics,proportion of antibiotics used,operation and postoperative complications between the two groups were compared.Results The pathological types between the two groups showed no statistically significant difference(χ~2=23.690,P=0.002),and no serious complications occurred after operation.Compared with the≤72 h group,the patients in the>72 h group had a higher proportion of antibiotics before admission(94.30%vs 82.21%,χ~2=10.361,P=0.037),longer operation time(t=3.998,P=0.029),and the amount of bleeding was more(t=2.368,P=0.035).Conclusion Laparoscopic appendectomy is safe and feasible for acute appendicitis patients with an onset time>72 hours,which can avoid secondary hospitalization,shorten the course of disease,reduce hospitalization costs and pain.