中国嘉兴在新冠疫情期间对急性阑尾炎的管理。
Managing acute appendicitis during the COVID-19 pandemic in Jiaxing, China.
作者信息
Zhou Yuan, Cen Lu-Sha
机构信息
Department of Gastrointestinal Surgery, The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing 31400, Zhejiang Province, China.
Department of Ophthalmology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China.
出版信息
World J Clin Cases. 2020 Oct 6;8(19):4349-4359. doi: 10.12998/wjcc.v8.i19.4349.
BACKGROUND
Coronavirus disease 19 (COVID-19) is a global pandemic and has had a profound impact on our routine surgical activities. Acute appendicitis is the most common abdominal emergency worldwide. Therefore, it is highly essential to assess the influence the pandemic has on acute appendicitis.
AIM
To assess the efficacy of the management of acute appendicitis during the COVID-19 pandemic.
METHODS
We retrospectively analyzed 90 patients who presented with acute appendicitis during the outbreak of COVID-19 in Jiaxing, China. Clinical data regarding appendectomies patients were also collected for the corresponding time frame from 2019. Preoperative management, intraoperative protective measures, and postoperative management were conducted.
RESULTS
After screening, six patients were identified as unqualified due to fever and were then referred to the COVID-19 expert group. The results of the nucleic acid test were negative. Of the 76 patients enrolled in the simple group, nine patients received medication therapy, and all others underwent surgery. From this same group, 66 patients were diagnosed with suppurative appendicitis, and one patient was diagnosed with perforated appendicitis after surgery. There were 14 patients in the complex group, for which the postoperative diagnosis indicated perforated appendicitis. The proportion of men with perforated appendicitis was higher than that in 2019 ( < 0.05). The chief complaint duration for perforated appendicitis patients in 2020 was longer than that in 2019 ( < 0.05). The routine blood test showed that white blood cell counts and neutrophil ratios were higher in perforated appendicitis patients in 2020 than in 2019 ( < 0.05). The ratio of open appendectomies to the amount of mean blood loss during surgery was greater in 2020 than in 2019 ( < 0.05). Online consultation after discharge was selected in 59 cases (65.6%). No perioperative infection with COVID-19 or long-term postoperative complications were found.
CONCLUSION
The management of acute appendicitis from Jiaxing effectively reduced the influence of the pandemic and minimized the risk of nosocomial infection.
背景
新型冠状病毒肺炎（COVID-19）是一场全球大流行疾病，对我们的常规外科手术活动产生了深远影响。急性阑尾炎是全球最常见的腹部急症。因此，评估这场大流行对急性阑尾炎的影响至关重要。
目的
评估COVID-19大流行期间急性阑尾炎的治疗效果。
方法
我们回顾性分析了在中国嘉兴COVID-19疫情爆发期间出现急性阑尾炎的90例患者。还收集了2019年相应时间段阑尾切除术患者的临床数据。进行了术前管理、术中保护措施和术后管理。
结果
筛查后，6例因发热被确定为不合格，随后转诊至COVID-19专家组。核酸检测结果为阴性。在纳入单纯组的76例患者中，9例接受药物治疗，其余均接受手术。在同一组中，66例被诊断为化脓性阑尾炎，1例术后被诊断为穿孔性阑尾炎。复杂组有14例患者，术后诊断为穿孔性阑尾炎。穿孔性阑尾炎男性患者的比例高于2019年（<0.05）。2020年穿孔性阑尾炎患者的主要症状持续时间长于2019年（<0.05）。常规血液检查显示，2020年穿孔性阑尾炎患者的白细胞计数和中性粒细胞比例高于2019年（<0.05）。2020年开放性阑尾切除术与手术期间平均失血量的比例高于2019年（<0.05）。59例（65.6%）患者选择出院后在线咨询。未发现围手术期感染COVID-19或长期术后并发症。
结论
嘉兴对急性阑尾炎的治疗有效降低了大流行的影响，并将医院感染风险降至最低。
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