成人非典型急性阑尾炎的临床特点及腹腔镜治疗效果分析  

Clinical characteristics of adult atypical acute appendicitis and clinical efficacy of laparoscopy

作　　者：张松泽 邬颖杰[1] 姚星明[1] 肖樟生[1] 

机构地区：[1]宁波市鄞州人民医院宁波大学医学院附属鄞州医院,浙江宁波315000

出　　处：《腹腔镜外科杂志》2016年第5期383-385,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨成人非典型急性阑尾炎的临床特点及腹腔镜治疗的临床疗效。方法:回顾分析2010年1月至2015年6月行腹腔镜阑尾切除术(laparoscopic appendectomy,LA)的365例成人急性阑尾炎患者的临床资料,其中典型急性阑尾炎281例(典型组),非典型急性阑尾炎84例(非典型组)。对比两组患者的一般资料及手术相关情况。结果:非典型组患者中49例考虑为阑尾炎可能,35例考虑为其他外科急腹症。两组患者性别、腹部手术史、合并粪石、阑尾病理类型差异无统计学意义(P>0.05)。非典型组高龄、合并内科疾病、特殊型阑尾炎、后位阑尾比例均高于典型组(P<0.05)。两组患者手术顺利,无围手术期死亡病例。两组中转开腹率、手术时间、手术出血量、引流管放置率及引流管留置时间差异无统计学意义(P>0.05)。非典型组术后住院时间、术后并发症发生率均明显长于或高于典型组,差异有统计学意义(P<0.05)。结论:成人非典型急性阑尾炎中老年人、合并内科疾病、特殊型阑尾炎、后位阑尾患者较多。腹腔镜手术治疗非典型急性阑尾炎安全、有效,但术后并发症发生率仍较高。Objective： To investigate the clinical characteristics of adult atypical acute appendicitis and clinical efficacy of laparoscopy. Methods： The clinical data of 365 patients with adult acute appendicitis who underwent laparoscopic appendectomy from Jan.2010 to Jun. 2015 were reviewed. Patients were divided into typical group with typical appendicitis（ n = 281） and atypical group with atypical appendicitis（ n = 84）. The general data and condition related to surgery between the two groups were compared. Results： In the atypical group,49 patients were suspected with acute appendicitis and 35 cases were considered with other surgical abdomen. No differences were found in the gender,history of abdominal surgery,stercoral appendicitis and type of pathology between the two groups（ P 〉0. 05）. The ratios of older age,cases along with medical disease,special type of appendicitis and retroposition appendix in the atypical group were higher than those in the typical group（ P 〈 0. 05）. All of the patients underwent the operation successfully and no perioperative death occurred. The differences in rate of conversion to laparotomy,operation time,blood loss,rate of drainage tube indwelling and the indwelling time between the two groups were not statistically significant（ P 〉 0. 05）. In the atypical group,hospital stay was longer and rate of postoperative complications was higher than those in the typical group（ P 〈 0. 05）. Conclusions： Adult patients with atypical appendicitis usually associate with advanced age,medical disease,special type appendicitis and retroposition appendix. Laparoscopy for adult atypical appendicitis is safe and feasible,but the rate of postoperative complications is still high.

关 键 词：阑尾炎 非典型性 腹腔镜检查 治疗结果 

分 类 号：R656.8[医药卫生—外科学]