小儿腹腔镜下阑尾切除术后30 d内再入院的影响因素分析<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.10.003

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Abstract 【Objective】To explore the influential factors affecting readmission within 30 days after laparoscopic appendectomy (LA) in children. 【Methods】The clinical data of 53 children with acute appendicitis who were readmitted within 30 days after LA in Hunan Children's Hospital from January 2019 to March 2024 were selected, and they were divided into the reoperation group (n=7) and non-reoperation group (n=46) according to whether they underwent reoperation or not. Age, sex, appendicitis inflammatory response score (AIR) at first admission, duration of first disease, duration of first hospital stay, pathological type, duration from first onset to admission, and duration of symptoms before readmission were collected. White blood cell (WBC) count, neutrophil lymphocyte ratio (NLR), and C-reactive protein (CRP) at first discharge and readmission, and risk factors associated with readmission within 30 days after LA were analyzed. 【Results】Among the 53 readmitted children, 22 cases (41.51%) were diagnosed with abdominal abscess, 19 cases with intestinal obstruction (35.85%), 6 cases with intestinal obstruction combined with abdominal abscess (11.32%), 5 cases with abdominal abscess combined with wound infection (9.43%), and 1 case with appendicitis (1.89%). At readmission, WBC count and NLR were higher than those at the first discharge (P<0.05), and CRP level was not significantly different from that at the first discharge (P>0.05). The rehospitalization time between the reoperation group and the non-reoperation group was statistically significant (P<0.05). There was no significant difference in AIR at first admission, time from first onset to admission, time of first hospitalization and duration of symptoms before readmission between the two groups (P>0.05). All 53 cases were discharged after treatment. 【Conclusion】The main readmission factors of appendicitis in children are abdominal abscess and intestinal obstruction. Early intervention can reduce the incidence of postoperative complications and the proportion of readmission children.

Key words： Appendicitis/SU Acute Disease Laparoscopy Appendectomy Root Cause Analysis

Received: 12 April 2024

PACS:

R726.568

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	LIAO Siqi
	JI Chunyi
	YUAN Miaoxian
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Cite this article:

LIAO Siqi,JI Chunyi,YUAN Miaoxian, et al. Analysis of Influencing Factors of Readmission within 30 Days after Laparoscopic Resection of Acute Appendicitis in Children[J]. JOURNAL OF CLINICAL RESEARCH, 2024, 41(10): 1465-1467.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2024.10.003 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2024/V41/I10/1465

[1] 褚忆忆,刘江斌.小儿急性阑尾炎治疗的研究进展[J].国际儿科学杂志,2020,47 (8): 531-534.
[2] BONADIO W.Time to appendectomy and risk of complicated appendicitis and adverse outcomes in children[J].JAMA Pediatr,2018,172(1): 94.
[3] 张利媛,运宏飞.超声检查在急性阑尾炎诊断中的价值[J].中国误诊学杂志,2021,16(2):147-148.
[4] ROLLE U,FAHLENBACH C,HEIDECKE C D,et al.Rates of complications after appendectomy in children and adolescents: pediatric surgical compared to general surgical hospitals[J].J Surg Res,2021,260:467-474.
[5] 张静,梁羽,陈琴,等.AIR评分联合超声预测小儿急性阑尾炎发生坏疽穿孔[J].中国超声医学杂志,2022,38(10):1161-1165.
[6] CHISTHI M M, SURENDRAN A, NARAYANAN J T. RIPASA and air scoring systems are superior to alvarado scoring in acute appendicitis: diagnostic accuracy study[J].Ann Med Surg (Lond),2020,59:138-142.
[7] TURHAN V B, ÜNSAL A, ÖZTÜRK B, et al. Predictive value of serum sodium level in determining perforated appendicitis[J].Ulus Travma Acil Cerrahi Derg,2022, 28(3):290-295.
[8] SAVERIO S D, PODDA M, SIMONE B D,et al.Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines[J].World J Emerg Surg,2020,15(1):27.
[9] ANDERSSON M, KOLODZIEJ B, ANDERSSON R E. Validation of the Appendicitis Inflammatory Response (AIR) score[J].World J Surg,2021,45(7):2081-2091.
[10] 郭彪.小儿急性阑尾炎术后因腹腔残余感染再入院的相关因素[D].江苏:苏州大学,2020.
[11] LAVERDE B L B, MAAK M, LANGHEINRICH M,et al.Risk factors for postoperative morbidity, prolonged length of stay and hospital readmission after appendectomy for acute appendicitis[J].Eur J Trauma Emerg Surg,2023,49(3):1355-1366.
[12] BHASKAR K, CLARKE S, MOORE L S P,et al.Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management[J].Ann Clin Microbiol Antimicrob,2023,22(1):45.
[13] BOUEIL A,GUÉGAN H,COLOT J,et al.Peritoneal fluid culture and antibiotic treatment in patients with perforated appendicitis in a Pacific Island[J].Asian J Surg,2015,38(4):242-246.
[14] 李涛,李巍松,王慧珍,等.儿童穿孔性阑尾炎的病原学分析及抗生素选用[J].宁夏医科大学学报,2022,44(2):203-206.
[15] 陈仲美,胡东来,陈俊杰,等.单联或二联抗生素治疗小儿复杂性阑尾炎的疗效分析[J].中国小儿急救医学,2017,24(7):532-535.
[16] 洪荣,叶建林.儿童急性阑尾炎抗感染方案的研究进展[J].药学与临床研究,2019,27(2):117-119.
[17] NATIONAL SURGICAL RESEARCH COLLABORATIVE.Multicentre observational study of performance variation in provision and outcome of emergency appendicectomy[J].Br J Surg,2013,100(9):1240-1252.
[18] 朱奎阳,陈刚,汤远银,等.腹腔镜与开腹手术治疗急性阑尾炎术后切口感染的危险因素分析[J].医学临床研究,2019,36(9):1805-1807.
[19] 陈宇航,刘晓明,利志波,等.腹腔镜阑尾切除术后非计划再手术16例原因分析[J].中国现代普通外科进展,2020,23(7):570-572.