Bhandari Tika Ram, Shahi Sudha, Acharya Sarita
Department of General Surgery, Universal College of Medical Sciences, Bhairahawa 32900, Nepal.
Department of ENT, National Academy of Medical Sciences, Kathmandu 44600, Nepal.
Int Sch Res Notices. 2017 Jul 20;2017:2636759. doi: 10.1155/2017/2636759. eCollection 2017.
Acute appendicitis is the commonest nonobstetric surgical emergency during pregnancy. The aim of the study was to compare perioperative outcomes of acute appendicitis in pregnant and nonpregnant patients.
A retrospective review of medical records of 56 pregnant patients between 2011 and 2016 who were compared with 164 nonpregnant women of reproductive age who underwent open appendectomy between 2014 and 2016 for acute appendicitis. The patient's demographics and perioperative data were analyzed.
The median age of pregnant and nonpregnant patients observed was 26 years (range 19-37) and 26 years (range 18-43). There were no significant differences between the groups in negative appendectomy (21.4 and 21.3%, = 0.52), perforated appendicitis (25 and 23.8%, = 0.85), postoperative complications (28.6 and 26.8%, = 0.80), and median length of hospital stay (5 and 4.5 days, = 0.36). There were 3.6% preterm labour, no maternal mortality, and no fetal loss. In multivariate analysis, WBC >18000/mm and long patient time to surgery were independent risk factors for appendicular perforation and postoperative complication ( < 0.05).
Our results of appendectomy in pregnant patients are comparable with nonpregnant patients. Hence the same perioperative treatment protocol can be followed in pregnant and nonpregnant patients even in resource-poor setting.
急性阑尾炎是孕期最常见的非产科外科急症。本研究旨在比较孕妇和非孕妇急性阑尾炎的围手术期结局。
回顾性分析2011年至2016年间56例孕妇的病历,并与2014年至2016年间因急性阑尾炎接受开腹阑尾切除术的164例育龄非孕妇进行比较。分析患者的人口统计学和围手术期数据。
观察到的孕妇和非孕妇的中位年龄均为26岁(范围19 - 37岁)和26岁(范围18 - 43岁)。两组在阴性阑尾切除术(21.4%和21.3%,P = 0.52)、穿孔性阑尾炎(25%和23.8%,P = 0.85)、术后并发症(28.6%和26.8%,P = 0.80)以及中位住院时间(5天和4.5天,P = 0.36)方面无显著差异。有3.6%的早产,无孕产妇死亡和胎儿丢失。多因素分析显示,白细胞计数>18000/mm³和患者至手术的时间长是阑尾穿孔和术后并发症的独立危险因素(P < 0.05)。
我们关于孕妇阑尾切除术的结果与非孕妇相当。因此,即使在资源匮乏的环境中,孕妇和非孕妇也可遵循相同的围手术期治疗方案。