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2019 年冠状病毒病、严重急性呼吸综合征冠状病毒 2 流行期间阑尾炎的处理:随着复杂病例的增加发病率是否降低?

Management of appendicitis in coronavirus disease 2019, severe acute respiratory syndrome coronavirus 2, pandemic era: decreasing incidence with increasing complicated cases?

机构信息

Giresun University Faculty of Medicine, Department of General Surgery - Giresun, Turkey.

Giresun University Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2022 May;68(5):685-690. doi: 10.1590/1806-9282.20220160.

Abstract

OBJECTIVE

This study aimed to examine the impact of the coronavirus disease 2019 (COVID-19) pandemic on appendicitis and the relevant outcomes in a tertiary hospital, designated as a "pandemic institution" by the Ministry of Health, between pre-COVID-19 and post-COVID-19, i.e., between 2019 and 2020, of the identical period in terms of the annual schedule.

METHODS

The data of cases with acute appendicitis, who were followed up at the Department of General Surgery, a 400-bed, tertiary care, a university-affiliated education and research hospital, providing health care to a population of approximately 450,000 people, during the novel coronavirus SARS-CoV-2, during the identical time intervals of pre-COVID-19 (March 12, 2020 to November 12, 2020) and post-COVID-19 (March 12, 2019 to November 12, 2019), were retrospectively analyzed in a detail.

RESULTS

Of the 212 appendectomy operations in total, 99 (46.7%) were performed in the pre-COVID-19 and 113 (53.3%) were performed in post-COVID-19. Compared to the pre-pandemic period, patients who had undergone appendectomies in post-COVID-19 revealed significantly lower neutrophil counts and significantly greater appendix diameters (p<0.001 for both). A significantly lower (p=0.041) acute appendicitis with abundant gangrenous appendicitis and phlegmonous appendicitis (p=0.043 and p=0.032, respectively) was recognized in post-COVID-19 compared with pre-COVID-19 interval.

CONCLUSION

The number of appendectomy operations decreased in the COVID-19 pandemic. Patients operated during the pandemic period had wider appendix diameter and lower neutrophil levels. The pathological diagnosis was less frequent acute appendicitis, more frequent gangrenous appendicitis, and phlegmonous appendicitis in the pandemic period.

摘要

目的

本研究旨在考察 2019 年冠状病毒病(COVID-19)大流行对三级医院阑尾炎的影响及相关结局,该医院被卫生部指定为“大流行机构”,研究对象为 2019 年和 2020 年同期,即 COVID-19 大流行前(2020 年 3 月 12 日至 11 月 12 日)和 COVID-19 大流行后(2019 年 3 月 12 日至 11 月 12 日)相同时间段内在普外科接受治疗的急性阑尾炎患者。

方法

对在一家拥有 400 张床位的三级医院普外科接受治疗的急性阑尾炎患者的病例资料进行回顾性分析,该医院是一所大学附属医院,从事教学和科研工作,服务人群约为 45 万人。在 SARS-CoV-2 新型冠状病毒流行期间,分析 2019 年和 2020 年同期(COVID-19 大流行前[2020 年 3 月 12 日至 11 月 12 日]和 COVID-19 大流行后[2019 年 3 月 12 日至 11 月 12 日])的阑尾切除术患者的详细数据。

结果

在总共 212 例阑尾切除术中,99 例(46.7%)发生在 COVID-19 大流行前,113 例(53.3%)发生在 COVID-19 大流行后。与大流行前相比,COVID-19 大流行后接受阑尾切除术的患者中性粒细胞计数显著降低,阑尾直径显著增大(均<0.001)。COVID-19 大流行后,急性阑尾炎伴大量坏疽性阑尾炎和蜂窝织炎的患者比例显著降低(分别为 p=0.041、p=0.043 和 p=0.032)。

结论

COVID-19 大流行期间阑尾切除术的数量减少。在大流行期间接受手术的患者阑尾直径更大,中性粒细胞水平更低。在大流行期间,病理诊断中急性阑尾炎的比例更低,坏疽性阑尾炎和蜂窝织炎的比例更高。

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