复杂阑尾切除术后的腹腔引流——资源浪费？

Abdominal Drainage in Complicated Appendicectomy - Resources Down the Drain?

机构信息

Whittington Hospital, UK.

出版信息

J Nepal Health Res Counc. 2021 Jan 21;18(4):672-675. doi: 10.33314/jnhrc.v18i4.2466.

DOI:10.33314/jnhrc.v18i4.2466

PMID:33510508

Abstract

BACKGROUND

There is currently no clear consensus on the use of drains during an appendicectomy to prevent abscess formation. Our aim was to ascertain whether the use of drains in complicated appendicitis reduces post-operative complications and length of stay.

METHODS

We performed a retrospective review of patients with complicated appendicitis undergoing appendicectomy from March-November 2018. Complicated appendicectomy (perforated or gangrenous appendicitis) patients were divided into two groups; with drain Group 1 (G1) and no drain Group 2 (G2). Groups were compared for post-operative complications and length of stay.

RESULTS

Out of a total 76 patients, 26 (34%) had drain (G1) and 50 (66%) had no drain (G2). The pre-operative CRP in G1 vs. G2 (124.8 vs. 48.3, p= 0.02); post-operative complication 9 (34.6%) vs. 6 (12%), p=0.019); intra-abdominal abscess 5 (19.2%) vs. 3 (6%), p=0.07 and LOS 5.5 days vs. 3 days, p=0.0001 were significantly higher in patients with a drain.

CONCLUSIONS

The use of an intra-operative drain in complicated appendicitis increases the risk of a post-operative complication and increases length of stay.

摘要

背景

目前对于在阑尾切除术中使用引流管以预防脓肿形成尚无明确共识。我们的目的是确定在复杂性阑尾炎中使用引流管是否能减少术后并发症和住院时间。

方法

我们对 2018 年 3 月至 11 月行阑尾切除术的复杂性阑尾炎患者进行了回顾性研究。将复杂性阑尾炎（穿孔性或坏疽性阑尾炎）患者分为两组：有引流组（G1 组）和无引流组（G2 组）。比较两组患者的术后并发症和住院时间。

结果

在总共 76 例患者中，26 例（34%）有引流管（G1 组），50 例（66%）无引流管（G2 组）。G1 组与 G2 组患者术前 CRP（124.8 vs. 48.3，p=0.02）；术后并发症 9（34.6%）vs. 6（12%），p=0.019）；腹腔脓肿 5（19.2%）vs. 3（6%），p=0.07；住院时间 5.5 天 vs. 3 天，p=0.0001）均显著更高。