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韩国某单一机构在 COVID-19 大流行期间行急诊阑尾切除术的临床经验。

Clinical Experience of Emergency Appendectomy under the COVID-19 Pandemic in a Single Institution in South Korea.

机构信息

Department of Surgery, College of Medicine, Inha University Hospital, Incheon 400-711, Korea.

出版信息

Medicina (Kaunas). 2022 Jun 9;58(6):783. doi: 10.3390/medicina58060783.

Abstract

Background and Objectives: The COVID-19 pandemic has brought serious changes in healthcare systems worldwide, some of which have affected patients who need emergency surgery. Acute appendicitis is the most common surgical disease requiring emergency surgery. This study was performed to determine how the COVID-19 pandemic has changed the treatment of patients with acute appendicitis in South Korea. Materials and Methods: We retrospectively reviewed a medical database that included patients who underwent surgery for acute appendicitis in our hospital from January 2019 to May 2021. We classified the patients into two groups according to whether they were treated before or after the COVID pandemic and 10 March 2020 was used as the cutoff date, which is when the World Health Organization declared the COVID pandemic. Results: A total of 444 patients were included in the “Pre-COVID-19” group and 393 patients were included in the “COVID-19” group. In the “COVID-19” group, the proportion of patients with severe morbidity was significantly lower. The time that the patients spent in the emergency room before surgery was significantly longer in the ”COVID-19” group (519.11 ± 486.57 min vs. 705.27 ± 512.59 min; p-value < 0.001). There was no difference observed in the severity of appendicitis or in the extent of surgery between the two groups. Conclusions: During the COVID-19 pandemic, a statistically significant time delay (186.16 min) was needed to confirm COVID-19 infection status. However, there was no clinical difference in the severity of appendicitis or in the extent of surgery. To ensure the safety of patients and medical staff, a COVID-19 PCR test should be performed.

摘要

背景与目的

COVID-19 大流行给全球医疗体系带来了重大变化,其中一些变化影响了需要急诊手术的患者。急性阑尾炎是最常见的需要急诊手术的外科疾病。本研究旨在确定 COVID-19 大流行如何改变韩国急性阑尾炎患者的治疗方式。

材料与方法

我们回顾性分析了一个医疗数据库,其中包括 2019 年 1 月至 2021 年 5 月在我院接受急性阑尾炎手术的患者。我们根据患者接受治疗的时间将其分为 COVID-19 大流行前组和 COVID-19 大流行后组,以 2020 年 3 月 10 日(世界卫生组织宣布 COVID-19 大流行的日期)为截止日期。

结果

共有 444 例患者纳入“COVID-19 大流行前”组,393 例患者纳入“COVID-19 大流行”组。在“COVID-19 大流行”组中,严重发病患者的比例显著降低。与“COVID-19 大流行”组相比,“COVID-19 大流行”组患者在急诊室接受手术前的时间明显更长(519.11 ± 486.57 min 比 705.27 ± 512.59 min;p 值<0.001)。两组患者的阑尾炎严重程度或手术范围均无差异。

结论

在 COVID-19 大流行期间,需要花费 186.16 分钟来确认 COVID-19 感染状态,这是一个显著的时间延迟。然而,阑尾炎的严重程度或手术范围在两组之间没有差异。为了确保患者和医务人员的安全,应进行 COVID-19 PCR 检测。

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