儿童腹腔镜急性阑尾炎切除术后粘连性肠梗阻的影响因素及护理

Factors Influencing Adhesive Bowel Obstruction and Care After Laparoscopic Resection of Acute Appendicitis in Children

目的:探究儿童腹腔镜急性阑尾炎切除术后粘连性肠梗阻的影响因素及护理。方法:选取2019年12月—2021年12月驻马店市中心医院收治的82例儿童腹腔镜急性阑尾炎患儿的病历资料进行回顾性分析,所有患儿行腹腔镜急性阑尾炎切除术。根据患儿的术后情况分为术后粘连性肠梗阻组、术后未出现粘连性肠梗阻组,并采用logistic多因素回归结果分析患儿腹腔镜急性阑尾炎切除术后粘连性肠梗阻的影响因素,提出术后护理对策。结果:术后未出现粘连性肠梗阻67例,占比81.71%。术后出现粘连性肠梗阻15例,占比18.29%。术后粘连性肠梗阻组病程25~72 h、手术创伤占比均高于术后未出现粘连性肠梗阻组,差异有统计学意义(χ^(2)=11.338、12.954,P<0.05)。结论:病程25~72 h和手术创伤均是儿童腹腔镜急性阑尾炎切除术后粘连性肠梗阻的影响因素,术后加强护理,减少手术创伤的影响。

Objective:To investigate the factors influencing and care of adhesive bowel obstruction after laparoscopic resection of acute appendicitis in children.Methods:The medical records of 82 children with laparoscopic acute appendicitis admitted to the hospital from December 2019 to December 2021,all of whom underwent laparoscopic resection of acute appendicitis,were selected for retrospective analysis.According to the postoperative condition of the children,they were divided into the group of postoperative adhesive intestinal obstruction and the group without postoperative adhesive intestinal obstruction.And logistic multifactorial regression was used to analyze the influencing factors of postoperative adhesive intestinal obstruction after laparoscopic acute appendicitis resection in children,and postoperative nursing countermeasures were proposed.Results:No postoperative adhesive bowel obstruction was observed in 67 cases,accounting for 81.71%.Postoperative adhesive bowel obstruction occurred in 15 cases,accounting for 18.29%.The postoperative adhesive intestinal obstruction group had a higher disease duration of 25~72 h and a higher percentage of surgical trauma than the postoperative non-adhesive intestinal obstruction group,and the difference was statistically significant(χ^(2)=11.338,12.954;P<0.05).Conclusion:Disease duration of 25~72 h and surgical trauma are both factors influencing adhesive bowel obstruction after laparoscopic resection of acute appendicitis in children,and postoperative care is enhanced to minimize the impact of surgical trauma.