老年急性阑尾炎诊断和治疗体会  

Understanding in Diagnosis and Therapy Progress of Acute Appendicitis in Elderly

作　　者：纵瑞杰 章密密[2] 杨军[2] 

机构地区：[1]江苏省徐州矿务集团三河尖矿医院普外科,221613 [2]江苏省徐州医学院第二附属医院普外科,221006

出　　处：《医学信息（下旬刊）》2010年第3期38-39,共2页Medical information

摘　　要：目的：总结老年急性阑尾炎的临床特点和诊断治疗经验。方法：回顾性分析35例65岁以上老年急性阑尾炎患者的，临床资料和诊治过程。结果：35例患者均有不同程度的合并症；29例（82．9％）急诊行阑尾切除术；3例（8．6％）为阑尾周围脓肿行引流术及二期阑尾切除术，2例（5．7％）为阑尾腺癌行回盲部切除术，1例（2．8％）为回盲部肿瘤伴穿孔行回肠造口术。结论：充分认识老年急性阑尾炎特点，积极处理合并症，早期积极手术治疗是治疗成功的关键；详询病史、细致检查，才能减少误诊和漏诊；积极防治术后并发症，加强围术期综合治疗才能提高疗效、降低死亡率。Purpose. Sums up clinical characteristic and diagnostic and therapeutic experience of acute appendicitis in elderly. Methods. This is a retrospective analysis of clinical data and treatment of 35 over 65 - year - old patients who underwent acute appendicitis. Results. In all 35 patients who have complications 29 example patients （82.9%） were diagnosed acute appendicitis and underwent appendectomy,3 patients （8.6%） were diagnosed abscess around the appendix and underwent drainage and secondary appendectomy, 2 patients （5.7 % ） were diagnosed appendix adenocarcinoma and underwent ileocecal resection, 1 patients （2.8%） were diagnosed ileocecal tumor and underwent ileostomy Conclusions. Most of these patients went to hospital lately , their clinical manifestation were not classical and prone to he made a wrong diagosis or missed diagosis. The incidence of gangrene and perforation were high. The patient could be cured by operation and had more complications and postoperative complications. Active operation should be selected preferentially. The doctors should diagnose the patient roundly and reduce the rate of misdiagosis and missing diagosis. Treatment to complications must be emphasized. Prevent and cure the postoperative complications actively, try one＇s best to improve the curative effect and reduce the death rate.

关 键 词：老年急性阑尾炎 诊断 治疗 

分 类 号：R656.8[医药卫生—外科学]