背景:盡管醫(yī)學(xué)診療有了很大的進(jìn)步,闌尾炎仍然是急腹癥最常見的原因之一。由于高血壓及其他一些心血管疾病會損害心肺功能,闌尾炎患者的既往疾病史對其預(yù)后有直接或間接的影響。因此,我們將合并有慢性疾病的患者與既往體健的患者對一對比研究目的:1.確定樣本特征2.比較高血壓和非高血壓患者腹腔鏡和開腹手術(shù)的療效(手術(shù)時間、術(shù)后鎮(zhèn)痛使用、術(shù)后喂養(yǎng)和住院時間)。3.探討高血壓患者和非高血壓患者的術(shù)后并發(fā)癥。4.探討高血壓和非高血壓患者的死亡率。方法:回顧性收集山東大學(xué)齊魯醫(yī)院急診外科2014-2018年行闌尾炎手術(shù)的成年患者。獲得的患者資料為;年齡、性別、既往腹部手術(shù)史、ASA危險評分、術(shù)前白細(xì)胞及中性粒細(xì)胞計數(shù)、影像學(xué)診斷、闌尾切除術(shù)類型、術(shù)中診斷、術(shù)后鎮(zhèn)痛使用、術(shù)后進(jìn)食時間、住院時間、術(shù)后并發(fā)癥及死亡率。納入標(biāo)準(zhǔn)為有臍周腹痛、發(fā)熱史的滿18歲的成人患者;術(shù)前超聲或CT確診闌尾炎的患者(蜂窩織樣闌尾炎、壞疽性闌尾炎、穿孔闌尾炎、闌尾膿腫)。排除標(biāo)準(zhǔn)為18歲以下患者、因其他原因切除闌尾及闌尾先天性缺失患者。描述性數(shù)據(jù)用平均數(shù)±標(biāo)準(zhǔn)差表示。分別采用獨(dú)立t檢驗和卡方檢驗分析連續(xù)變量和分類變量之間的相關(guān)性。單因...

【文章頁數(shù)】：56 頁

【學(xué)位級別】：碩士

【文章目錄】：
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
學(xué)位論文評閱及答辯情況表
附件



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