标准化的患者护理指南可降低阑尾炎切除术患者的感染发病率。
Standardized patient care guidelines reduce infectious morbidity in appendectomy patients.
作者信息
Helmer Kenneth S, Robinson Emily K, Lally Kevin P, Vasquez J C, Kwong Karen L, Liu Terrence H, Mercer David W
机构信息
Department of Surgery, The University of Texas-Houston Medical School and LBJ General Hospital, 5656 Kelley St., Ste. 3-OS 62008, Houston, TX 77026, USA.
出版信息
Am J Surg. 2002 Jun;183(6):608-13. doi: 10.1016/s0002-9610(02)00860-7.
BACKGROUND
Surgical wound infection and intra-abdominal abscess remain common infectious complications after appendectomy, especially in the setting of a perforated or gangrenous appendix. We therefore developed a clinical protocol for the management of appendicitis to decrease postoperative infectious complications.
METHODS
Between January 1, 1999, and December 31, 1999, 206 patients with appendicitis were treated on protocol. Retrospectively, the charts were reviewed for all protocol patients as well as for 232 patients with appendicitis treated in the year prior to protocol initiation. Data were collected on surgical wound infections and intra-abdominal abscesses.
RESULTS
There were significantly fewer infectious complications in the protocol group than in the nonprotocol group (20 [9%] versus 8 [4%]; P <0.05). In patients with a perforated or gangrenous appendix, the infectious complication rate was reduced from 33% to 13% (P <0.05).
CONCLUSIONS
The incidence of infectious complications after appendectomy can be significantly reduced with a standardized approach to antibiotic therapy and wound management.
背景
手术伤口感染和腹腔内脓肿仍是阑尾切除术后常见的感染性并发症，尤其是在阑尾穿孔或坏疽的情况下。因此，我们制定了一项阑尾炎管理的临床方案，以减少术后感染性并发症。
方法
在1999年1月1日至1999年12月31日期间，206例阑尾炎患者按方案接受治疗。回顾性地审查了所有方案患者以及方案启动前一年接受治疗的232例阑尾炎患者的病历。收集了有关手术伤口感染和腹腔内脓肿的数据。
结果
方案组的感染性并发症明显少于非方案组（20例[9%]对8例[4%]；P<0.05）。在阑尾穿孔或坏疽的患者中，感染性并发症发生率从33%降至13%（P<0.05）。
结论
采用标准化的抗生素治疗和伤口管理方法可显著降低阑尾切除术后感染性并发症的发生率。
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