合并或不合并慢性疾病的阑尾炎经腹腔镜手术和开放手术结果的回顾性研究

发布时间：2025-06-21 04:11

　　背景:尽管医学诊疗有了很大的进步,阑尾炎仍然是急腹症最常见的原因之一。由于高血压及其他一些心血管疾病会损害心肺功能,阑尾炎患者的既往疾病史对其预后有直接或间接的影响。因此,我们将合并有慢性疾病的患者与既往体健的患者对一对比研究目的:1.确定样本特征2.比较高血压和非高血压患者腹腔镜和开腹手术的疗效(手术时间、术后镇痛使用、术后喂养和住院时间)。3.探讨高血压患者和非高血压患者的术后并发症。4.探讨高血压和非高血压患者的死亡率。方法:回顾性收集山东大学齐鲁医院急诊外科2014-2018年行阑尾炎手术的成年患者。获得的患者资料为;年龄、性别、既往腹部手术史、ASA危险评分、术前白细胞及中性粒细胞计数、影像学诊断、阑尾切除术类型、术中诊断、术后镇痛使用、术后进食时间、住院时间、术后并发症及死亡率。纳入标准为有脐周腹痛、发热史的满18岁的成人患者;术前超声或CT确诊阑尾炎的患者(蜂窝织样阑尾炎、坏疽性阑尾炎、穿孔阑尾炎、阑尾脓肿)。排除标准为18岁以下患者、因其他原因切除阑尾及阑尾先天性缺失患者。描述性数据用平均数±标准差表示。分别采用独立t检验和卡方检验分析连续变量和分类变量之间的相关性。单因...

【文章页数】：56 页

【学位级别】：硕士

【文章目录】：
ABSTRACT
摘要
CHAPTER1.INTRODUCTION
    1.1 Definition and general concept
        1.1.1 Acute appendicitis
        1.1.2 Pathophysiology
        1.1.3 Epidemiology
        1.1.4 Clinical features
        1.1.5 Diagnosis
        1.1.6 Scoring system
    1.2 Literature review
        1.2.1 Risk factors
        1.2.2 Management
        1.2.3 Complications
        1.2.4 Comparison of LA and OA with socio-demographic characteristics
        1.2.5 Duration of surgery between LA and OA
        1.2.6 Length of hospital stay between OA and LA
        1.2.7 Initiation of oral feeding between LA and OA
        1.2.8 Ambulation between LA and OA
        1.2.9 Hospital cost between LA and OA
        1.2.10 Postoperative complications between LA and OA
    1.3 Appendicectomy and pregnancy/obesity/chronic pain
    1.4 Conversion
    1.5 Justification of the study
    1.6 Rationale of the study
CHAPTER2.METHODOLOGY
    2.1 Study design and study population
    2.2 Data collection procedure
    2.3 Data management and statistical analysis
    2.4 Ethical consideration
CHAPTER3.RESULTS
    3.1 Socio-demographic characteristics and other patient's characteristics
    3.2 Comparison of surgical outcomes among hypertensive and non- hypertensive patients in relationto the type of appendectomy
        3.2.1 Duration of operation
        3.2.2 Post-operative analgesia
        3.2.3 Post-operative initiation of oral feeding
        3.2.4 Post-operative complications
        3.2.5 Length of hospital stay
    3.3 Other factors associated with poor surgical outcomes
        3.3.1 ASA risk score
        3.3.2 Pre-operative WBCs
        3.3.3 Pre-operative neutrophil count
        3.3.4 Intra-operative diagnosis
CHAPTER4.DISCUSSION
    4.1 Other factors associated with poor surgical outcomes
    4.2 Mortality
CHAPTER5.CONCLUSION
REFERENCES
Acknowledgement
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