阑尾残株炎9例的临床观察  

Clinical Observation about the Nine Cases of Stump Appendicitis(SA)

作　　者：王率[1] 范恩学[1] 王旻[1] 吴元玉[1] 张相森[1] 张虎[1] 

机构地区：[1]吉林大学第二医院普通外科,吉林长春130041

出　　处：《现代生物医学进展》2013年第34期6657-6660,共4页Progress in Modern Biomedicine

摘　　要：目的：总结阑尾残株炎的病因、诊断方法、预防和治疗措施，为临床提供更多的参考依据。方法：回顾性分析我院2011年1月～2013年1月收治的9例阑尾残株炎患者的临床资料，并查阅相关文献，总结阑尾残株炎的病因和诊疗方法等。结果：阑尾残端过长（〉1cm）是导致阑尾残株炎发生的主要原因。结合血常规、钡剂灌肠透视、CT、彩超等检查，必要时行腹腔镜探查可确诊阑尾残株炎。及时行手术切除阑尾残株是阑尾残株炎主要治疗方法。本组5例患者行传统开腹阑尾残端切除术（残端双重结扎，保留残端0．2～0．3cm），2例行腹腔镜阑尾残端切除术（钛夹夹闭阑尾残端，保留阑尾残端0．2～0．3cm），2例行部分盲肠切除术，回盲部留置引流管。2例患者出现切口感染，9例患者均痊愈。结论：预防阑尾残株炎的主要措施是是尽量完善阑尾切除手术。对已行阑尾切除术的患者再次出现右下腹部疼痛时等类似阑尾炎症状时，临床医生应考虑阑尾残株炎的可能，进一步行钡剂灌肠透视检查及腹部超声等辅助检查，必要时行腹腔镜腹腔探查以确诊，并应根据患者具体情况及时行手术切除阑尾残株。Objective： To summarize the pathogenesis, diagnosis, prevention and treatment measures of stump appendicitis（SA）, and to provide more references for the clinic. Methods： The clinical data of nine cases of SA who were treated in our hospital from Jan- uary 2011 to January 2013 were analyzed retrospectively, and a systematic review of the literature about SA was undertaken, and the eti- ology, diagnosis and treatment measures of SA were summarized. Results： A overlong appendix stump （〉lcm） was the primary reason for SA, which could be diagnosed by the ombination of blood routine with barium enema examination, computed tomography （CT） and color doppler ultrasound and the laparoscopic exploration was also in necessary. Timely surgical excision of appendix stump was the main treatment method for SA. This appendix stump resection in 5 cases with the traditional laparotomy（the pedicles were double ligated, keeping the end of 0.2-0.3 cm）, in 2 cases underwent laparoscopic appendix stump resection （Titanium cliped appendix stump, keeping the end of0.2-0.3 cm）, in 2 cases with partial resection of the cecum and drainage tube was indwelled in ileocecal region. Incision infec- tion was observed in 2 cases, all of the 9 cases were cured finally. Conclusion： The primary measure to prevent SA was to perfect the ap- pendectomy. SA should be taken into consideration if a patient suffered right side abdominal pain and a history prior appendectomy, and further examination such as barium enema examination and color doppler ultrasound, laparoscopic exploration should be taken to make final diagnosis in necessary, then the surgical measure should be taken according to the specific situation.

关 键 词：阑尾炎 阑尾残株炎 诊断 治疗 预防 

分 类 号：R656.8[医药卫生—外科学]