腹腔镜与开腹阑尾切除术后手术部位感染的临床对比分析

目的探讨腹腔镜与开腹阑尾切除术后手术部位感染的发生情况，为制定预防与控制措施提供依据。方法回顾性分析2007年1月～2012年10月在我院行阑尾切除术的374例患者的临床资料。根据手术方式不同分为腹腔镜阑尾切除术组（216例）和开腹阑尾切除术组（158例）。比较两组手术时间、术后肛门排气时间、住院时间、术后肠梗阻、术后30d内再住院和手术部位感染的差异。结果两组在手术时间、术后肛门排气时间、住院时间、切口浅部感染和总手术部位感染方面，差异有统计学意义（P〈0．05）；在术后肠梗阻、术后30天内再住院、切口深部感染和腹腔脓肿方面，差异无统计学意义（P〉0．05）。结论与开腹阑尾切除术相比，腹腔镜阑尾切除术有着术后肠道功能恢复快和住院时间短等微创优势，同时可显著降低术后发生切口浅部感染和总手术部位感染的风险。

Clinical analysis of laparoscopic versus open appendectomy postoperative surgical site infection

Objective To explore the laparoscopic and open appendectomy occurrence of postoperative surgical site infection, and to provide the basis for the development of prevention and control measures. Methods The clinical data of 374 patients who underwent appendectomy from January 2007 to October 2012 were retrospectively analyzed. These patients were divided into two groups according to the different surgical approaches： the laparo- scopic appendectomy group（216 cases） and the open appendectomy group（158 cases）. The differences of the op- eration time, postoperative anal exhaust time, length of hospital stay, postoperative ileus, postoperative readrnission within 30 days and surgical site infections were compared between the two groups. Results The differences of the operation time, postoperative anal exhaust time, length of hospital stay, incision superficial infection and overall SSI were statistically significant between the LA groups and OA groups（ P 〈 0.05）. But the differences of postop- erative ileus, postoperative readmission within 30 days, incision deep infection and intra - abdominal abscess were no statistically significant（ P 〉 0.05）. Conclusion Compared with open appendectomy, LA with minimally inva- sive advantages may lead to a faster postoperative recovery of bowel function and a shorter length of hospital stay. While LA can significantly reduce the risk of postoperative incision superficial infection and overall SSI.