台州地区穿孔性阑尾炎患儿流行病学调查及相关影响因素分析  

Epidemiological survey and analysis of related influencing factors of children with perforated appendicitis in Taizhou area

作　　者：金丽虹[1] 张林娟 於林军[1] 胡文辉[3] JIN Lihong;ZHANG Linjuan;YU Linjun;HU Wenhui(Department of Pediatric Surgery,Taizhou Hospital of Zhejiang Province,Zhejiang Province,Taizhou 317000,China;Gastrointestinal Anorectal Pediatric Surgery,Taizhou Central Hospital(Taizhou University Hospital),Zhejiang Province,Taizhou 318000,China;Pediatric Internal Medicine,Taizhou Hospital of Zhejiang Province,Zhejiang Province,Taizhou 317000,China)

机构地区：[1]浙江省台州医院小儿外科,浙江台州317000 [2]浙江省台州市中心医院(台州学院附属医院)胃肠肛肠小儿外科,浙江台州318000 [3]浙江省台州医院小儿内科,浙江台州317000

出　　处：《中国医药导报》2023年第12期60-63,69,共5页China Medical Herald

基　　金：浙江省医药卫生科技计划项目(2023KY1306);浙江省台州市科学计划项目(1801ky21)。

摘　　要：目的调查台州地区穿孔性阑尾炎儿童的流行病学调查及相关高危因素,为临床有效地治疗儿童穿孔性阑尾炎提供依据。方法选取浙江省台州医院、台州恩泽医疗中心集团恩泽医院、台州中心医院2017年1月至2021年12月小儿外科住院治疗的529例阑尾炎患儿的临床资料,按照是否穿孔分为穿孔组123例和非穿孔组406例,收集两组临床指标,对穿孔性阑尾炎的发生进行独立危险因素分析。结果两组发热、畏寒、厌食、腹痛、腹泻、转移性右下腹痛、腹部压痛及肌紧张、行动缓慢、身体前驱比较,差异无统计学意义(P>0.05)。穿孔性组发病至手术时间、首诊B超检查、户籍农村比较、CT报告及术中发现阑尾粪石、体重指数高于未穿孔阑尾炎组,差异有统计学意义(P<0.05)。多因素logistic结果显示,发病至手术时间[OR(95%CI):2.259(1.449~3.519)],首诊超声检查[OR(95%CI):2.347(1.402~3.930)],CT报告及术中发现阑尾粪石[OR(95%CI):2.076(1.337~3.225)],体重指数[OR(95%CI):1.943(1.188~3.178)]是儿童发生穿孔性阑尾炎的危险因素(P<0.05)。结论儿童穿孔性阑尾炎具有多项高危因素,医护人员在诊疗过程中应关注上述体征及辅助检查,避免向危重症发展。Objective To investigate the epidemiological survey and related high-risk factors of perforated appendicitis in children in Taizhou area,and to provide a basis for effective clinical treatment of perforated appendicitis in children.Methods The clinical data of 529 children with appendicitis hospitalized in pediatric surgery from January 2017 to December 2021 in Taizhou Hospital of Zhejiang Province,Enze Medical Hospital,and Taizhou Central Hospital,Zhejiang Province were selected and divided into 123 cases in the perforated group and 406 cases in the non-perforated group according to whether they were perforated,and the clinical indicators of both groups were collected for independent risk factor analysis of the occurrence of perforated appendicitis.Results There was no statistically significant difference between the two groups when comparing fever,chills,anorexia,abdominal pain,diarrhea,metastatic right lower abdominal pain,abdominal pressure and muscle tension,slow movement,and body anterior drive(P<0.05).The time from onset to surgery,first ultrasound examination,rural proportion of household registration,CT report,and intraoperative finding of appendicular fecal stone,and body mass index were higher in the perforated group than those in the non-perforated appendicitis group,and the differences were statistically significant(P<0.05).Multifactorial logistic results showed that time from onset to surgery(OR[95%CI]:2.259[1.449-3.519]),first ultrasound examination(OR[95%CI]:2.347[1.402-3.930]),CT report and intraoperative finding of appendiceal fecal stone(OR[95%CI]:2.076[1.337-3.225]),and body mass index(OR[95%CI]:1.943[1.188-3.178])were risk factors for the development of perforated appendicitis in children(P<0.05).Conclusion Perforated appendicitis in children has several high-risk factors,and health care providers should pay attention to the above-mentioned signs and ancillary tests during the treatment process to avoid progression to critical illness.

关 键 词：穿孔性阑尾炎 儿童 流行病学 影响因素 

分 类 号：R656.8[医药卫生—外科学]