【摘要】 目的：探讨小儿腹腔镜阑尾切除术(LA)后发生腹腔脓肿(IAA)的影响因素。方法：选取2013年1月—2020年2月行LA的952例阑尾炎患儿，按术后是否发生腹腔脓肿分为腹腔脓肿组(42例)和无腹腔脓肿组(910例),对两组患儿年龄、性别、发病时间、术前炎症指标、手术时间、术中出血量、腹腔冲洗情况、腹腔引流情况、阑尾炎临床类型(复杂和非复杂)、阑尾病理分型、住院时间和抗生素使用时间进行比较，采用单因素和多因素分析探讨IAA发生的危险因素。结果：单因素分析结果显示，两组术前C反应蛋白(CRP)含量、阑尾炎临床类型及是否进行腹腔冲洗方面比较，差异有统计学意义(P<0.05)。多因素分析结果显示，术中腹腔冲洗及放置腹腔引流管均可降低术后IAA发生的风险[OR=0.318,95%CI(0.133～0.760),P=0.010;OR=0.429,95%CI(0.199～0.924),P=0.031];而术前CRP>69.31 mg/L是术后IAA发生的危险因素[OR=2.194,95%CI(1.039～4.633),P=0.039];复杂阑尾炎与术后腹腔IAA发生风险增加有关[OR=2.658,95%CI(1.211～5.834),P=0.015]。结论：术后IAA的发生与腹腔感染的严重程度、是否进行腹腔冲洗及腹腔引流等多因素密切相关。掌握规范合理的腹腔冲洗手术技巧，合理放置腹腔引流管有助于减少LA术后IAA的发生。更多还原

【Abstract】 Objective: To investigate the risk factors of abdominal abscess(IAA) after laparoscopic appendectomy(LA) in pediatric patients.Methods: The clinical data of 952 cases of pediatric appendicitis treated by laparoscopic surgery were retrospectively analyzed and divided into abdominal abscess group and no abscess group according to whether abdominal abscess occurred after surgery.The age, gender, the time required for preoperative diagnosis, preoperative inflammatory index, operation time, intraoperative bleeding, abdominal irrigation, abdominal drainage, clinical type of appendicitis(complicated and uncomplicated),appendicular pathological typing, hospitalization time and antibiotic use time of the two groups were compared, and the risk factors for the occurrence of IAA were clarified by single-factor analysis and multifactor analysis.Results: The results of univariate analysis showed that the preoperative C-reaction protein(CRP) level, clinical type of appendicitis, and whether or not to perform intraperitoneal irrigation differed between the two groups(P<0.05).The results of multifactorial analysis showed that both intraoperative abdominal irrigation and placement of abdominal drainage tubes reduced the risk of postoperative IAA [OR=0.318,95%CI(0.133～0.760),P=0.010;OR=0.429,95%CI(0.199～0.924),P=0.031].Preoperative CRP>69.31 mg/L was a risk factor for postoperative IAA[OR=2.194,95%CI(1.039～4.633),P=0.039],and complex appendicitis was associated with an increased risk of postoperative abdominal IAA[OR=2.658,95%CI(1.211～5.834),P=0.015].Conclusion: The occurrence of postoperative IAA is closely related to the severity of abdominal infection, abdominal irrigation and abdominal drainage, etc.Mastering standardized and reasonable abdominal irrigation surgical techniques and placing abdominal drains can help reduce the occurrence of postoperative IAA in LA.更多还原