SLA与OA治疗急性阑尾炎的效果对比及术后切口感染的Logistic分析  

Comparison of the effect of SLA and OA in the treatment of acute appendicitis and Logistic analysis of postoperative incision infection

作　　者：王瑞 陈虎 WANG Rui;CHEN Hu(Department of General Surgery,Sihong Hospital,Sihong 223900,China)

机构地区：[1]泗洪医院普外科,宿迁泗洪223900

出　　处：《东南大学学报(医学版)》2025年第1期144-149,共6页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:经脐单孔腹腔镜阑尾切除术(SLA)与开放式阑尾切除术(OA)治疗急性阑尾炎(AA)的效果比较及患者术后切口感染的危险因素Logistic分析。方法:选取于本院接受SLA的44例AA患者作为研究组,另选择同期于本院接受OA的40例AA患者作为对照组,比较两组手术效果;统计84例患者术后切口感染发生率,多因素Logistic回归分析术后切口感染的危险因素。结果:研究组手术持续时间、术后肛门初次排气时间、下床活动时间、进食时间及住院时间均明显短于对照组,术中出血量和温哥华瘢痕量表评分明显低于对照组,住院费用高于对照组(均P<0.05)。术后1、3 d,研究组血清皮质醇(cortisol,Cor)、去甲肾上腺素(noradrenaline,NE)水平明显低于对照组(P<0.05)。研究组术后切口感染发生率为6.82%,明显低于对照组的25.00%(P<0.05)。发生术后切口感染的AA患者与未发生患者年龄、病程、病理类型、手术方式、手术时间比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄(>60岁)、手术方式(OA)、病理类型(坏疽穿孔性或化脓性)、病程(>24 h)、手术时间(>1 h)为AA患者术后切口感染的危险因素。结论:SLA治疗AA效果优于OA,可缩短患者恢复时间,降低术后切口感染发生率,同时应密切关注AA患者切口感染的高危因素,做好相应预防措施,以促进患者快速康复。Objective:The effects comparison of transumbilical single-port laparoscopic appendectomy(SLA)and open appendectomy(OA)in the treatment of acute appendicitis(AA)and Logistic analysis of the risk factors for postoperative wound infection in patients.Methods:A total of 44 patients with acute appendicitis who underwent SLA in our hospital were selected as the study group,and 40 patients who underwent OA in our hospital during the same period were selected as the control group.The surgical effects of the two groups were compared.The incidence of postoperative incision infection in 84 patients was counted,and the risk factors for postoperative incision infection were analyzed by multivariate Logistic regression.Results:The operation duration,initial anal gas dischange time,off-bed activity time,eating time and hospitalization time of the surgical group were significantly shorter than those of the control group,and the intraoperative blood loss and Vancouver Scar Scale score were significantly lower than those in the control group,and the hospitalization cost was higher than that in the control group(P<0.05).1 and 3 days after surgery,the levels of serum cortisol(Cor)and noradrenaline(NE)in the study group were significantly lower than those in the control group(P<0.05).The incidence of postoperative incision infection in the study group was 6.82%,which was significantly lower than that in the control group(25.00%)(P<0.05).There were significant differences in age,course of disease,pathological type,surgical method,and operation time between AA patients with postoperative incision infection and those without(P<0.05).The results of multivariate logistic regression analysis showed that age(>60 years old),surgical method(OA),pathological type(gangrenous perforation or suppurative),course of disease(>24 h)and operation time(>1 h)were risk factors for postoperative incision infection in AA patients.Conclusion:SLA is more effective than OA in treating AA,for it can shorten the patient's recovery time and reduce the incidence

关 键 词：急性阑尾炎 经脐单孔腹腔镜阑尾切除术 开放式阑尾切除术 术后切口感染 

分 类 号：R656.8[医药卫生—外科学]