摘要
目的探讨急性阑尾炎手术患者就诊前时段、就诊时段、住院后手术时段与阑尾病理分型及术后并发症的关系 .方法对 2 052例手术和病理确诊的急性阑尾炎患者 ,将术前 12个变量数据化后 ,建立数据库 , SAS软件分析各变量与阑尾病理分型及术后并发症的关系 .结果 (1)就诊前延迟：单纯性阑尾炎平均 23 4 h,进展性 35 3 h；无并发症组 23 1 h,有并发症组 34 4 h(两者 P=0.0001) . (2)就诊间延迟：单纯性阑尾炎平均 2 3 h,进展性 3 3 h( P >0 05)；无并发症组 2 3 h,有并发症组 3 0 h( P=0 0499) . (3)住院后手术延迟：单纯性阑尾炎平均 2 7 h,进展性 2 6 h；无并发症组 2 7 h,有并发症组 2 9 h(两者 P >0 05) . (4)logistic回归分析示： 3个时段中 ,就诊前延迟是最有意义的变量 .结论就诊前延迟是影响急性阑尾炎病理分型和术后并发症的主要因素 ,而就诊间延迟、住院后手术延迟影响不大 .
Objective To investigate the correlation of delayed surgery of acute appendicitis to its pathology and postoperative complications. Methods From Jan.1996 to Jun.1999, 2 052 cases of acute appendicitis in our hospital were correctly diagnosed by operation and pathology. Twelve preoperative digitized variables were made and a data base was set up. The correlation of these variables with pathology and postoperative complications were analyzed using SAS software. Results (1) The delay of pre- hospitalization: simple appendicitis averaged 23 4 hours, advanced appendicitis 35 3 hours; patient group without postoperative complications averaged 23.1 hours, group with complications averaged 34 4 hours (both P=0.0001). (2) Delay in the outpatient or emergency department: simple appendicitis averaged 2 3 hours, advanced appendicitis 3 3 hours(P >0 05); patients group without postoperative complications averaged 2 3 hours, group with complications averaged 3 0 hours (P=0 0499). (3)Delay after admission: simple appendicitis averaged 2 7 hours, advanced appendicitis 2 6 hours; patients group without postoperative complications averaged 2 7 hours, group with complications averaged 2 9 hours (both P >0 05). (4)Logistic regression: Pre- hospitalization delay was the ultimate significant variable among the three delays. Conclusions Pre- hospitalization delay is the main factor which affects the pathology and the postoperative complications of acute appendicitis, however the effect of other two delays is not significant.
关键词
阑尾炎
急性
手术
延迟
病理
手术后并发症
Appendicitis, acute
Surgery, delay
Pathology
Postoperative complication
