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[1990 - 2001年挪威的阑尾炎与阑尾切除术]

[Appendicitis and appendectomy in Norway 1990-2001].

作者信息

Bakken Inger Johanne, Skjeldestad Finn Egil, Mjåland Odd, Johnson Egil

机构信息

Seksjon for epidemiologisk forskning, SINTEF Unimed, Trondheim.

出版信息

Tidsskr Nor Laegeforen. 2003 Nov 20;123(22):3185-8.

Abstract

BACKGROUND

The purpose of this study was to examine the incidence of appendicitis and appendectomy in Norway from 1990 to 2001.

METHODS

Data were compiled from the Norwegian Patient Registry based on ICD-9 and ICD-10 codes for appendicitis and appendectomy. Re-admissions after appendectomy were selected based on institution and allocation numbers for hospitalisation.

RESULTS

Age-adjusted incidence rates for appendectomy were 117 per 100 000 for men and 116 per 100 000 for women. Incidence rates were highest among patients aged 10-29. Diagnostic accuracy increased from 81% to 86% in men and from 60% to 71% in women over the study period. Perforation ratio increased from 12% to 21% in men and from 9% to 17% in women. Appendectomy by laparoscopic technique increased during 1998 to 2001 from 5% to 10% of cases for men and from 9% to 15% of cases for women. The proportion of laparoscopic appendectomy was considerably higher in two counties (50% and 28% in 2000-2001). Length of hospital stay was shorter after laparoscopy (median two days) than after open surgery (median three days), with no difference in the rate of re-admission of 4%.

INTERPRETATION

Diagnostic accuracy and perforation ratio increased over the 1990s. Patients operated upon with laparoscopic technique had shorter hospital stays and the same re-admission rate compared to patients undergoing conventional surgery. Though the proportion of appendectomies done by laparoscopy doubled from 1998 to 2001, the procedure is not in commonly use in Norway.

摘要

背景

本研究旨在调查1990年至2001年挪威阑尾炎及阑尾切除术的发病率。

方法

数据取自挪威患者登记处,依据国际疾病分类第九版(ICD - 9)和第十版(ICD - 10)中阑尾炎及阑尾切除术的编码。阑尾切除术后的再次入院病例是根据住院机构及住院分配编号选取的。

结果

经年龄调整后的阑尾切除术发病率,男性为每10万人中有117例,女性为每10万人中有116例。发病率在10至29岁的患者中最高。在研究期间,男性的诊断准确率从81%提高到86%,女性从60%提高到71%。穿孔率男性从12%升至21%,女性从9%升至17%。1998年至2001年期间,采用腹腔镜技术进行的阑尾切除术,男性病例占比从5%增至10%,女性病例占比从9%增至15%。在两个县,腹腔镜阑尾切除术的比例相当高(2000 - 2001年分别为50%和28%)。腹腔镜检查后的住院时间(中位数为两天)比开放手术后(中位数为三天)短,再次入院率均为4%,无差异。

解读

20世纪90年代诊断准确率和穿孔率有所提高。与接受传统手术的患者相比,采用腹腔镜技术手术的患者住院时间更短,再次入院率相同。尽管从1998年到2001年,腹腔镜阑尾切除术的比例翻了一番,但该手术在挪威并未普遍使用。

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