急性阑尾炎术后并发症发生与平均住院时间延长的相关因素分析  

Relevant factors analysis for the occurrence of postoperative complications and the prolongation of average hospitalization time in patients with acute appendicitis

作　　者：徐逸昕[1] 谭玉林[1] 王一波[1] 丁蔚 徐学忠[1] 

机构地区：[1]江苏大学附属武进医院普外科二,江苏常州213002

出　　处：《当代医学》2017年第27期23-26,共4页Contemporary Medicine

摘　　要：目的探讨急性阑尾炎术后并发症发生与平均住院时间延长的相关因素。方法采用回顾性病例分析方法。收集1 693例行阑尾切除术患者的临床病理资料。发生术后并发症患者为220例。以中位住院时间为截点,选取住院时间≥6 d的定义为住院时间延长组(626例),<6 d定义为非住院时间延长组(1 067例)。分析性别、年龄、预防性使用抗生素、手术方式、炎症严重程度对术后并发症及平均住院时间之间的影响。结果单因素分析显示:预防性抗生素、手术方式、炎症严重程度是发生术后并发症的危险因素(c2=47.939,7.191,33.031,P<0.05);年龄、手术方式、炎症严重程度是平均住院时间延长的危险因素(c2=41.443,26.847,29.944,P<0.05)。多因素结果分析显示:不预防性使用抗生素、复杂性阑尾炎是影响患者发生术后并发症的独立危险因素(OR=2.378,1.422,95%可信区间1.593~3.551,1.008~2.007,P<0.05);高龄、开腹手术、复杂性阑尾炎是影响患者平均住院时间延长的独立危险因素(OR=1.666,2.072,1.411,95%可信区间1.166~2.381,1.498~2.866,1.076~1.805,P<0.05)。结论不预防性使用抗生素、复杂性阑尾炎与患者发生术后并发症密切相关,高龄、开腹手术、复杂性阑尾炎与患者平均住院时间延长密切相关。术前应详细了解患者的一般情况以及炎症严重程度,个体化治疗,减少术后并发症,缩短住院时间。Objective To investigate the related factors of the postoperative complications and the prolongation of average hospitalization time in patients with acute appendicitis.Methods The clinical and pathological data of 1693 patients undergoing appendectomy were collected by using the retrospective case analysis.220 patients suffered postoperative complications.Median hospitalization time was served as a cut-off point,626 patients with hospitalization time ≥6 days and 1067 patients with hospitalization time 6 days were allocated into the long time group and short time group,respectively.The influence of gender,age,prophylactic use of antibiotics,the mode operation,the severity of inflammation on postoperative complications and average hospitalization time were analyzed.Results The univariate analysis showed that the prophylactic use of antibiotics,the mode of operation and the severity of inflammation were the factors affecting the occurrence of postoperative complications（χ^2=47.939,7.191,33.031,p〈0.05）.The age,the mode of operation and the severity of inflammation were factors affecting the prolongation of the average hospitalization time（χ^2=41.443,26.847,29.944,p〈0.05）.The multivariate analysis showed that the lack of prophylactic antibiotics and complicated acute appendicitis were independent risk factors affecting the occurrence of postoperative complications（OR=2.378,1.422 95% CI 1.593-3.551,1.008-2.007,p〈0.05）.The advanced age,traditional open surgery and complicated acute appendicitis were independent risk factors affecting the prolongation of the average hospitalization time（OR=1.666,2.072,1.411 95%CI 1.166-2.381,1.498-2.866,1.076-1.805,p〈0.05）.Conclusion The postoperative complications are closely associated with The lack of prophylactic antibiotics and complicated acute appendicitis.The prolongation of the average hospitalization time is closely associated with advanced age,traditional open surgery and complicated acute appendicitis.We should detailedly acquaint the general situ

关 键 词：急性阑尾炎 并发症 住院时间 危险因素 

分 类 号：R656.8[医药卫生—外科学]