阑尾切除术切口感染因素分析及防治探讨

目的分析阑尾切除术切口感染的多种因素及探讨防治措施。方法回顾性分析我院近15年间收治各种类型阑尾炎1 360例的临床资料。全部病例均行阑尾切除术。结果1360例均治愈。术后切口感染48例,总感染率3.53%(48/1360)。其中单纯性阑尾炎881例,切口感染10例,占1.14%;慢性阑尾炎103例,无切口感染。化脓性阑尾炎232例,切口感染3例,占1.29%。坏疽性阑尾炎或阑尾穿孔144例,切口感染35例,占24.31%。结论针对单纯性、化脓性、坏疽性阑尾炎或阑尾穿孔术后可能引起切口感染的相关因素,提出对该病早期诊断、及时手术;注意切口妥加保护,避免长时间的手术操作,正确使用和安放腹腔引流物;合理选用抗生素,术后密切观察切口的炎症变化,早期处理,积极治疗与阑尾炎并存的呼吸道感染、肺结核、糖尿病等合并症,就能有效地将切口感染率降低到最低限度。

Incision infection after appendectomy

Objective To investigate factors associated with incision infection after appendectomy and its prevention.Methods Clinical data of 1360 patients with different types of appendicitis treated with appendectomy in preceding 15 years were retrospectively analyzed.Results All the 1360 patients were cured.Incision infection was found in 48 patients,overall infection rate was 3.53%.Of 881 patients with uncomplicated appendicitis,incision infection was found in 10 patients(1.14%).There was no incision infection in 103 patients with chronic appendicitis.Of 232 patients with suppurative appendicitis,incisions infection was found in 3 patients(1.29%).Of 144 patients with gangrenous appendicitis or perforating appendicitis,incisions infected was found in 35 patients(24.31%)(P<0.05 or P<0.005,respectively).Conclusion Incision infection is more likely to happen in some types of appendicitis.Appendicitis should be diagnosed and treated as early as possible.Special attention should be paid to protection of incision,avoidance of prolonged operation,correct application of drainage of abdominal cavity,reasonable use of antibiotics,active treatment of coexisting conditions,such as respiratory infection,pulmonary tuberculosis,diabetes,etc.All of these measures can effectively reduce the rate of incision infection.