儿童穿孔性阑尾炎术后胃肠功能恢复情况及其危险因素分析  

Postoperative recovery of gastrointestinal function in children with perforated appendicitis and its risk factors

作　　者：黄振文 吕昌恒[1] 唐海洲[1] 张东虎 杨迪 何昌景 罗克德 HUANG Zhenwen;LYU Changheng;TANG Haizhou;ZHANG Donghu;YANG Di;HE Changjing;LUO Kede(Department of Pediatric Surgery,Affiliated Hospital of Youjiang Medical University of Nationalities,Guangxi Zhuang Autonomous Region,Youjiang 533000,China)

机构地区：[1]右江民族医学院附属医院小儿外科,广西右江533000

出　　处：《中国当代医药》2022年第20期109-112,共4页China Modern Medicine

摘　　要：目的观察儿童穿孔性阑尾炎术后胃肠功能恢复情况,并对其影响因素进行分析。方法回顾性选取2017年1月至2021年8月在广西右江民族医学院附属医院行手术治疗的160例穿孔性阑尾炎患儿作为研究对象,比较不同临床特征患儿的胃肠功能恢复评价指标(肠鸣音恢复时间、肛门排气时间、排便时间),采用多因素logistic回归模型分析术后胃肠功能恢复不良的危险因素。结果160例患儿术后胃肠道功能恢复良好136例,恢复不良24例。单因素分析结果显示,术后胃肠道功能恢复情况与发病至手术时间、手术方式、手术时间、CO_(2)气腹压、腹腔冲洗液、术后照顾者及术后并发症、术后干预相关,差异有统计学意义(P<0.05)。采用logistic回归模型进行多因素分析,结果显示,开腹手术(β=0.274,OR=1.249,95%CI=1.022~1.615)、手术时间≥60 min(β=0.285,OR=1.358,95%CI=1.097~1.704)、CO_(2)气腹压≥12 mmHg(β=0.382,OR=1.375,95%CI=1.119~1.762)、术后有并发症(β=0.241,OR=1.218,95%CI=1.064~1.637)、术后无干预(β=0.338,OR=1.276,95%CI=1.025~1.696)是术后胃肠道功能恢复情况的独立危险因素(P<0.05)。结论儿童穿孔性阑尾炎术后胃肠道功能恢复不良的危险因素较多,应当采取针对性干预措施以促进其胃肠道功能恢复。Objective To observe the postoperative recovery of gastrointestinal function in children with perforated appendicitis and analyze its risk factors.Methods A total of 160 children with perforated appendicitis underwent surgical treatment enrolled in Affiliated Hospital of Youjiang Medical University of Nationalities from January 2017 to August 2021 were selected retrospectively as research objects.The evaluation indexes of gastrointestinal function recovery(bowel sound recovery time,anal exhaust time,defecation time)were compared among children with different clinical characteristics.The multivariate logistic regression was used to analyze the risk factors in postoperative poor recovery of gastrointestinal function.Results There were 136 children with postoperative good recovery of gastrointestinal function and 24 children with postoperative poor recovery of gastrointestinal function in 160 children.Univariate analysis results showed that the postoperative recovery of gastrointestinal function was correlated with the time from onset to operation,operation method,operation time,CO_(2) pneumoperitoneum pressure,peritoneal washes,postoperative caregivers,postoperative complications,postoperative intervention,and the differences were statistically significant(P<0.05).Multivariate logistic regression model analysis showed that the laparotomy(β=0.274,OR=1.249,95%CI=1.022-1.615),operation time≥60 min(β=0.285,OR=1.358,95%CI=1.097-1.704),CO_(2) pneumoperitoneum pressure≥12 mmHg(β=0.382,OR=1.375,95%CI=1.119-1.762),postoperative complications(β=0.241,OR=1.218,95%CI=1.064-1.637),without postoperative intervention(β=0.338,OR=1.276,95%CI=1.025-1.696)were the independent risk factors in postoperative recovery of gastrointestinal function(P<0.05).Conclusion There were many risk factors of postoperative poor recovery of gastrointestinal function in children with perforated appendicitis,so targeted intervention measures should be taken to promote gastrointestinal function recovery.

关 键 词：穿孔性阑尾炎 儿童 术后恢复 胃肠功能 危险因素 

分 类 号：R726.5[医药卫生—儿科]