中老年急性阑尾炎患者合并糖尿病的临床发病特点及其切口感染的影响因素  

Analysis of clinical characteristics of middle-aged and elderly patients with acute appendicitis complicated with diabetes and influencing factors of incision infection

作　　者：田希贵 陈泽刚 TIAN Xi-gui;CHEN Ze-gang(Department of General surgery,The People's Hospital of Liangping District,Chongqing,Chongqing405200,China)

机构地区：[1]重庆市梁平区人民医院普外科,重庆405200

出　　处：《吉林医学》2022年第7期1764-1767,共4页Jilin Medical Journal

基　　金：重庆市科卫联合医学科研项目[项目编号:2021MSXM289]。

摘　　要：目的:探讨中老年急性阑尾炎(AA)患者合并糖尿病(DM)的临床发病特点及其切口感染的影响因素。方法:回顾性分析就诊的1500例中老年AA患者术后的病历资料,其中合并DM组280例,不合并DM组1220例。比较两组患者间各临床特点的差异,通过单因素及多因素分析法分析影响DM组中老年AA患者切口感染的因素。结果:DM组中老年AA患者阑尾坏疽穿孔率为31.0%,高于非DM组的21.2%,差异有统计学意义(P=0.014);腹膜炎体征发生率44.6%,高于非DM组的29.8%,差异有统计学意义(P=0.001)。单因素分析显示:年龄、体重指数、发病时间、病理类型、手术方式、手术时间、入院前使用抗生素与切口感染相关。Logistic回归分析显示:发病时间、病理类型、手术方式、术后平均血糖是影响DM组中老年AA患者术后切口感染的独立危险因素。结论:与不合并DM的中老年AA患者相比,合并DM的中老年AA患者具有腹部体征相对较重、阑尾更易发生坏疽或穿孔的特点;早诊断、早手术、选择恰当的手术方式以及术后良好的控制血糖可降低其术后切口感染率。Objective To explore the clinical characteristics of middle-aged and elderly patients with acute appendicitis(AA)combined with diabetes(diabetes mellitus,DM)and the influencing factors of incision infection.Method Retrospective analysis of postoperative medical records of 1500 middle-aged and elderly patients with AA who were treated.280 patients were classified into DM group and 1220 patients were classified into the non-DM group.This study compared the differences in clinical characteristics between DM and non-DM groups.Analysis of factors affecting wound infection in middle-aged and elderly AA patients in the DM group by single factor and multivariate analysis.Results The perforation rate of appendix gangrene in middle-aged and elderly AA patients in the DM group was 31.0%,which was higher than that in the non-DM group 21.2%(P=0.014);the incidence of signs of peritonitis was 44.6%,which was higher than that in the non-DM group 29.8%(P=0.001).Univariate analysis showed that age,body mass index,time of onset,pathological type,operation method,operation time,and antibiotic use before admission were related to incision infection.Logistic regression analysis showed that the time of onset,pathological type,surgical methods,and average postoperative blood glucose were independent risk factors affecting postoperative wound infection in middle-aged and elderly AA patients in the DM group.Conclusion Compared with middle-aged and elderly AA patients without DM,middle-aged and elderly AA patients with DM have relatively heavier abdominal signs and are more prone to gangrene or perforation of the appendix;early diagnosis,early surgery,selection of appropriate surgical methods,and good postoperative Control of blood sugar can reduce the rate of postoperative wound infection.

关 键 词：阑尾炎 糖尿病 切口感染 

分 类 号：R587.2[医药卫生—内分泌] R574.61[医药卫生—内科学]