不接触、不冲洗、不引流操作对阑尾切除术后并发症的影响  

Significance of no contacting, no washing and no draining to reduce the complications of appendectomy

作　　者：万厚民[1] 张应丽[1] 王辉[1] 李金文[1] 李海[1] 王震宇[1] 

机构地区：[1]济南市第四人民医院普通外科,250031

出　　处：《中国医师进修杂志（外科版）》2006年第10期28-29,32,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨阑尾切除术中采用不接触、不冲洗、不引流操作(“三不操作”)对阑尾切除术后并发症的影响。方法将急性化脓性阑尾炎232例患者随机分为两组,即采用“三不操作”组(A组)和“非三不操作”组(B组),每组116例。阑尾切除术中采用的“三不操作”为(1)不接触避免切口直接或间接地接触阑尾或脓液。(2)不冲洗不管阑尾是否穿孔、脓液多少均不冲洗腹腔而采用纱布将腹腔脓液重点有序地蘸除。(3)不引流在彻底清除腹腔脓液后不放置引流管。结果随访3年,A组切口感染4例,腹腔脓肿2例,腹壁炎性包块1例,粘连性肠梗阻3例。B组切口感染13例,腹腔脓肿9例,腹壁炎性包块7例,粘连性肠梗阻12例。两组比较差异有统计学意义(P<0.05)。结论阑尾切除术中采用“三不操作”可有效降低切口感染、腹腔脓肿、腹壁炎性包块及粘连性肠梗阻的发生率,值得提倡。Objective To study the significance of no contacting,no washing and no draining （ ＂3 no operation＂ ） namely on the complications of appendectomy. Methods Two hundred and thirty - two cases of acute suppurative appendicitis were divided into two groups randomly. Group A adopted ＂ 3 no operation＂, while group B did not. No contacting： to prevent the appendix and pus of abdominal cavity from the wound directly or indirectly. No washing： the pus was eliminated orderly by gauzes without the abdominal cavity washing. No draining： no drainage tube was used in any cases. All cases were fol- lowed up for 3 years. Results Group A or B had 4 or 13 cases of incision infection, 2 or 9 cases of abdominal cavity abscess, 1 or 7 cases of abdominal wall inflammatory mass, 3 or 12 cases of adhesive intestinal ileus respectively. There were significant differences between the two groups （P 〈 0.05）. Conclusions ＂3 no operation＂ in appendectomy could effectively reduce the complications such as wound infection and adhesive intestinal ileus and so on.

关 键 词：阑尾炎 化脓性 阑尾切除术 并发症 

分 类 号：R656.8[医药卫生—外科学]