摘要
目的:探讨腹腔冲洗对成人急性阑尾炎伴腹膜炎的治疗效果.方法:回顾分析2017年9月至2020年12月为急性阑尾炎伴腹膜炎患者行腹腔镜阑尾切除术的临床资料,将患者分为腹腔冲洗组与非冲洗组.对比两组患者年龄、性别、术前体温、外周血白细胞计数、中性粒细胞百分比、手术时间、腹腔脓液量、病理类型、术后住院时间、术后进食时间、术后抗生素使用时间、术后引流管放置时间、术后白细胞恢复正常时间、腹腔感染率、切口感染率等.结果:共纳入147例急性阑尾炎伴腹膜炎患者,腹腔冲洗组63例,非冲洗组84例.两组患者年龄、性别、体温、外周血白细胞计数、中性粒细胞百分比、腹腔脓液量、病理分型差异无统计学意义(P＞0.05),腹腔冲洗组手术时间、术后进食时间、术后住院时间、抗生素使用时间、引流管放置时间及术后外周血白细胞恢复正常时间长于非冲洗组(P＜0.05),两组腹腔感染率、切口感染率差异无统计学意义(P＞0.05).结论:腹腔冲洗应用于腹腔镜阑尾切除术中并不能有效减少成人急性阑尾炎伴腹膜炎患者术后腹腔感染、切口感染的发生,反而延长了手术时间、术后恢复时间,不利于患者恢复,因此不推荐常规冲洗.
Abstract
Objective:To investigate the therapeutic effect of abdominal irrigation on adult acute appendicitis with peritonitis.Methods:The clinical data of adult patients with acute appendicitis and peritonitis who underwent laparoscopic appendectomy from Sep.2017 to Dec.2020 were retrospectively analyzed.They were randomly divided into two groups(abdominal irrigation group and non-irrigation group).The age,gender,preoperative body temperature,peripheral blood leukocyte count,neutrophil percentage,operation time,abdominal abscess volume,pathological type,postoperative hospital stay,postoperative feeding time,postoperative antibiotic use time,postoperative drainage tube placement time,postoperative leukocyte recovery time,abdominal infection incidence,incision infection incidence were compared between the two groups.Results:A total of 147 adult patients with acute appendicitis and peritonitis were included in this study,including abdominal irrigation group(n=63)and non-irrigation group(n=84).There was no significant diffe-rence in age,gender,body temperature,peripheral blood leukocyte count,neutrophil percentage,abdominal abscess volume and patho-logical classification between the two groups(P＞0.05).The operation time,postoperative feeding time,postoperative hospital stay,anti-biotic use time,drainage tube placement time and postoperative leukocyte recovery time in the abdominal irrigation group were longer than those in the non-irrigation group(P＜0.05),while incidence of abdominal infection and incision infection between the two groups were not significantly different(P＞0.05).Conclusions:The application of abdominal irrigation in laparoscopic appendectomy cannot effectively reduce the incidence of postoperative abdominal infection and incision infection in adults with acute appendicitis with perito-nitis,but prolongs the operation time and postoperative recovery time.It is not conducive to the recovery of patients,so routine irrigation is not recommended.
维普
万方数据