[1]张长海.腹腔镜阑尾切除术腹腔脓肿影响因素分析[J].医学信息,2021,34(10):131-133.[doi:10.3969/j.issn.1006-1959.2021.10.037]
 ZHANG Chang-hai.Analysis of Influencing Factors of Abdominal Abscess in Laparoscopic Appendectomy[J].Medical Information,2021,34(10):131-133.[doi:10.3969/j.issn.1006-1959.2021.10.037]
点击复制

腹腔镜阑尾切除术腹腔脓肿影响因素分析()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年10期
页码:
131-133
栏目:
临床研究
出版日期:
2021-05-15

文章信息/Info

Title:
Analysis of Influencing Factors of Abdominal Abscess in Laparoscopic Appendectomy
文章编号:
1006-1959(2021)10-0131-03
作者:
张长海
(天津市滨海新区中医医院外科,天津 300451)
Author(s):
ZHANG Chang-hai
(Department of Surgery,Binhai New Area Hospital of TCM,Tianjin 300451,China)
关键词:
腹腔脓肿阑尾切除术腹腔镜
Keywords:
Abdominal abscessAppendectomyLaparoscopy
分类号:
R656.8
DOI:
10.3969/j.issn.1006-1959.2021.10.037
文献标志码:
A
摘要:
目的 探讨腹腔镜阑尾切除术(LA)后发生腹腔脓肿的危险因素。方法 选取2018年1月~2020年6月在我院行LA治疗后并发腹腔脓肿的68例急性阑尾炎患者作为腹腔脓肿组,另选取术后未发生腹腔脓肿68例急性阑尾炎患者作为无腹腔脓肿组,比较两组体重指数(BMI)、性别、术前病程、年龄、术中出血量、手术时间、是否放置引流管、实施腹腔冲洗、术后使用抗生素时间等资料,分析LA术后患者发生腹腔脓肿的危险因素。结果 腹腔脓肿组年龄≥50岁、腹腔冲洗、手术时间≥50 min、抗生素使用时间≥5 d比例高于无腹腔脓肿组,差异有统计学意义(P<0.05);两组BMI、性别、术前病程、术中出血量、放置引流管比较,差异无统计学意义(P>0.05);Logistic回归分析显示,腹腔冲洗、手术时间≥50 min是LA术后并发腹腔脓肿的独立危险因素。结论 LA术后并发腹腔脓肿与腹腔冲洗、手术时间等多种因素密切相关,手术医生需掌握熟练的腹腔镜操作技术,术中避免不必要的腹腔冲洗,以降低腹腔脓肿发生率。
Abstract:
Objective To investigate the risk factors of abdominal abscess after laparoscopic appendectomy (LA).Methods 68 patients with acute appendicitis who had abdominal abscess after LA treatment in our hospital from January 2018 to June 2020 were selected as the abdominal abscess group.In addition, 68 patients with acute appendicitis who did not develop abdominal abscess after operation were selected as the non-abdominal abscess group.Compare the two groups’ body mass index (BMI), gender, preoperative course of disease, age, intraoperative blood loss, operation time, whether to place a drainage tube, perform abdominal cavity irrigation, and use antibiotics after surgery.To analyze the risk factors of abdominal abscess in patients after LA.Results The proportion of the abdominal abscess group with age ≥50 years, abdominal cavity washing, operation time ≥50 min, and antibiotic use time ≥5 d was higher than that in the abscess group without abdominal abscess, the difference was statistically significant (P<0.05);There was no statistically significant difference in BMI, gender, preoperative course of disease, intraoperative blood loss, and drainage tube placement between the two groups (P>0.05);Logistic regression analysis showed that abdominal cavity washing and operation time ≥50 min were independent risk factors for abdominal abscess after LA.Conclusion The complications of abdominal abscess after LA are closely related to various factors such as abdominal irrigation and operation time. The surgeon needs to master skilled laparoscopic operation techniques and avoid unnecessary abdominal irrigation during the operation to reduce the incidence of abdominal abscess.

参考文献/References:

[1]李光强,蔡弥松,肖志博,等.连续硬膜外麻醉对老年急性阑尾炎患者行腹腔镜阑尾切除术后切口感染发生率及血清TNF-α、CRP水平的影响[J].中国老年学杂志,2019,39(19):4750-4753.[2]张素燕,韩加刚,马连港,等.腹腔镜与开腹手术治疗急性化脓性阑尾炎及坏疽性阑尾炎的临床疗效对比[J].中国临床医生杂志,2019,47(5):573-575.[3]杜嘉原,汪富涛.腹腔镜阑尾切除术治疗急性阑尾炎临床疗效及术后并发症研究[J].陕西医学杂志,2019,48(2):179-182.[4]张昕,李毅,柏立山,等.腹腔镜阑尾切除术中阑尾根部及系膜不同处理方式的比较[J].蚌埠医学院学报,2019,44(4):481-483.[5]陈瑜峰,崔华雷,李贵斌.腹腔镜手术治疗小儿阑尾周围脓肿22例报告[J].中国微创外科杂志,2017,17(9):787-789.[6]吴孟超,吴在德.黄家驷外科学[M].第7版.北京:人民卫生出版社,2008:225-226.[7]姜笑明,黄文海,俞建平.腹腔镜阑尾切除术与开腹阑尾切除术的对比研究[J].复旦学报(医学版),2018,45(2):221-226.[8]Sun F,Wang H,Zhang F,et al.Copious Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Complicated Appendicitis in Adults[J].J Invest Surg,2017,31(4):1-5.[9]张建国,张瑞敏,徐永康,等.IL-6、CRP在小儿阑尾周围脓肿行腹腔镜手术中的临床观察[J].内蒙古医科大学学报,2019,41(3):266-268.[10]Francisco S,Emmanuel ES,Pea ME,et al.Laparoscopic Appendectomy:Risk Factors for Postoperative Intraabdominal Abscess[J].World J Surg,2017,41(5):1254-1258.[11]Lasek A,Michal P,Michal W,et al.Risk factors for intraabdominal abscess formation after laparoscopic appendectomy–results from the Pol-LA(Polish Laparoscopic Appendectomy) multicenter large cohort study[J].Wideochir Inne Tech Maloinwazyjne,2019,14(1):70-78.

相似文献/References:

[1]王 蕾,苏华斌,肖冠英,等.急性阑尾炎合并艾滋病患者临床病理特点及其对手术方式的影响[J].医学信息,2018,31(20):45.[doi:10.3969/j.issn.1006-1959.2018.20.014]
 WANG Lei,SU Hua-bin,XIAO Guan-ying,et al.Clinicopathological Features of Acute Appendicitis Complicated with AIDS and its Effect on Surgical Methods[J].Medical Information,2018,31(10):45.[doi:10.3969/j.issn.1006-1959.2018.20.014]
[2]鲁留平.腹腔镜系膜剥离法阑尾切除术与腹腔镜常规阑尾切除术的效果比较[J].医学信息,2021,34(21):103.[doi:10.3969/j.issn.1006-1959.2021.21.027]
 LU Liu-ping.Comparison of Application Value Between Laparoscopic Mesangial Stripping Appendectomy and Laparoscopic Conventional Appendectomy[J].Medical Information,2021,34(10):103.[doi:10.3969/j.issn.1006-1959.2021.21.027]
[3]孙忠博.腹壁缝合穿刺针辅助小儿腹腔镜阑尾切除术的临床疗效与优势研究[J].医学信息,2023,36(03):140.[doi:10.3969/j.issn.1006-1959.2023.03.029]
 SUN Zhong-bo.Study on the Clinical Efficacy and Advantages of Laparoscopic Appendectomy Assisted by Abdominal Wall Suture Puncture Needle in Children[J].Medical Information,2023,36(10):140.[doi:10.3969/j.issn.1006-1959.2023.03.029]

更新日期/Last Update: 1900-01-01