腹腔镜阑尾切除术后腹腔冲洗、腹腔引流的临床分析

Clinical Analysis of Abdominal Irrigation and Abdominal Drainage after Laparo⁃scopic Appendectomy

目的探讨腹腔冲洗、腹腔引流在改善腹腔镜阑尾切除术后患者存在的右下腹疼痛、肩背部疼痛、腹胀等不适症状中的应用。方法选取2019年1月—2020年12月南京医科大学附属苏州医院收治的急性阑尾炎患者60例为研究对象,随机分为两组,A组为未冲洗无引流组,B组为冲洗+引流组,每组30例。比较两组患者术后24 h右下腹疼痛程度、肩背部疼痛发生率、肛门排气时间、下床活动时间、白细胞恢复正常时间、腹腔残余感染发生率、术后肠梗阻发生率。结果B组术后24 h右下腹疼痛程度评分(3.26±0.67)分、肛门排气时间(20.25±2.32)h、白细胞恢复正常时间(2.92±0.38)d、肩背部疼痛发生率3.33%、腹腔残余感染发生率0.00%均优于A组,差异有统计学意义(t=4.793、6.232、4.451,P<0.05;χ^(2)=3.606、4.630,P<0.05);两组下床活动时间、术后肠梗阻发生率比较,差异无统计学意义(P>0.05)。结论腹腔冲洗、腹腔引流能有效改善了腹腔镜阑尾切除术后患者存在的右下腹疼痛、肩背部疼痛、腹胀等一系列不适症状。

Objective To explore the application of abdominal irrigation and abdominal drainage in improving the discomfort symptoms such as right lower quadrant pain,shoulder and back pain,abdominal distension in patients after laparoscopic appendectomy.Methods A total of 60 patients with acute appendicitis admitted to Suzhou Hospital Affiliated to Nanjing Medical University from January 2019 to December 2020 were selected as the research objects.They were randomly divided into two groups,group A was the non-flushing and no-drainage group,and group B was the flushing+drainage group,with 30 cases in each group.The pain degree of the right lower quadrant,24 hours after surgery the incidence of shoulder and back pain,the time of anal exhaust,the time to get out of bed,the time for white blood cells to return to normal,the incidence of residual abdominal infection,and the incidence of postoperative intestinal obstruction were compared between the two groups of patients.Results The patients in group B had a right lower quadrant pain score(3.26±0.67)points,anal exhaust time(20.25±2.32)h,white blood cell recovery time(2.92±0.38)d,and the incidence of shoulder and back pain was 3.33%,The incidence of residual intra-abdominal in⁃fection was 0.00%higher than that of group A,and the difference was statistically significant(t=4.793,6.232,4.451,P<0.05;χ^(2)=3.606,4.630,P<0.05);there was no statistically significant difference in the time of getting out of bed and the incidence of postoperative intestinal obstruction between the two groups(P>0.05).Conclusion Abdominal irrigation and abdominal drainage can effectively improve a series of dis⁃comfort symptoms such as right lower quadrant pain,shoulder and back pain,abdominal distension in patients after laparoscopic appendectomy.