基层医院小切口手术治疗阑尾炎的可行性及切口感染的危险因素分析  

Feasibility of Small Incision Surgery for Appendicitis in Grassroots Hospitals and Analysis of Risk Factors for Incision Infection

作　　者：龙军军 LONG Junjun(Department of Surgery,Neikeng Town Health Center,Jinjiang 362268,China)

机构地区：[1]晋江市内坑镇卫生院外科,晋江362268

出　　处：《中国医药指南》2024年第27期11-13,共3页Guide of China Medicine

摘　　要：目的探讨基层医院小切口手术治疗阑尾炎的可行性及切口感染的危险因素。方法选取2021年5月至2023年5月晋江市内坑镇卫生院收治的阑尾炎患者60例,均实施小切口手术治疗。依据术后有无发生感染将患者分为感染组(8例)和未感染组(52例)。回顾性收集患者临床资料,通过单因素分析与多因素Logistic回归分析以明确切口感染的危险因素。结果60例阑尾炎患者均顺利完成小切口手术治疗,切口长度为(3.61±0.98)cm,术中出血量为(19.13±2.26)ml,手术时间为(52.93±4.07)min,肛门排气时间为(21.23±3.75)h,住院时间为(3.92±0.68)d,并发症总发生率为15.00%(切口感染8例、肠粘连1例);感染组年龄≥60岁、体质量指数(BMI)≥24 kg/m^(2)、手术时间≥60 min、化脓性/坏疽及穿孔性阑尾炎、逆行切除阑尾的患者占比与未感染组相比更高(P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁(OR 2.629)、BMI≥24 kg/m^(2)(OR 2.341)、手术时间≥60 min(OR 2.129)、化脓性/坏疽及穿孔性阑尾炎(OR 1.356)、逆行切除阑尾(OR 1.820)是影响小切口手术治疗阑尾炎后切口感染的独立危险因素(P<0.05)。结论基层医院小切口手术治疗阑尾炎的可行性较高,但部分患者术后发生切口感染,需要重点关注年龄、BMI、手术时间、阑尾炎类型、阑尾切除方式等危险因素。Objective To explore the feasibility of small incision surgery for appendicitis in grassroots hospitals and the risk factors of incision infection.Methods A total of 60 patients with appendicitis admitted to Neikeng Town Health Center in Jinjiang City from May 2021 to May 2023 were selected.All patients underwent small incision surgery and were divided into an infected group(8 cases)and an uninfected group(52 cases)based on whether infection occurred after surgery.Retrospective collection of clinical data from patients,and identification of risk factors for incision infection through univariate analysis and multivariate Logistic regression analysis.Results All 60 patients with appendicitis successfully completed small incision surgery,with an incision length of(3.61±0.98)cm,intraoperative bleeding of(19.13±2.26)ml,surgery time of(52.93±4.07)minutes,anal exhaust time of(21.23±3.75)hours,hospital stay of(3.92±0.68)days,and a total incidence of complications of 15.00%(8 cases of incision infection and 1 case of intestinal adhesions).The proportion of patients with age≥60 years old,body mass index(BMI)≥24 kg/m^(2),surgery time≥60 minutes,purulent/gangrenous and perforated appendicitis,and retrograde appendectomy in the infected group was higher than that in the non infected group(P<0.05).The results of multivariate Logistic regression analysis showed that age≥60 years old(OR 2.629),BMI≥24 kg/m^(2)(OR 2.341),surgical time≥60 minutes(OR 2.129),purulent/gangrenous and perforated appendicitis(OR 1.356),and retrograde appendectomy(OR 1.820)were independent risk factors for incision infection after small incision surgery for appendicitis(P<0.05).Conclusions Small incision surgery in grassroots hospitals is highly feasible for treating appendicitis,but some patients may experience incision infections after surgery,and it is necessary to focus on risk factors such as age,BMI,surgical time,type of appendicitis,and appendectomy method.

关 键 词：阑尾炎 基层医院 小切口手术 可行性 切口感染 危险因素 

分 类 号：R656.8[医药卫生—外科学]