急性阑尾炎合并艾滋病患者临床病理特点及其对手术方式的影响  

Clinicopathological Features of Acute Appendicitis Complicated with AIDS and its Effect on Surgical Methods

作　　者：王蕾 苏华斌[2] 肖冠英[1] 卢琼 WANG Lei;SU Hua-bin;XlAO Guan-ying;LU Qiong(Department of Pathology,Guangzhou Eighth People＇s Hospital,Guangzhou 510000,Guangdong,China;Department of Surgery,Guangzhou Eighth People＇s Hospital,Guangzhou 510000,Guangdong,China;Hunan University of Medicine,Huaihua 418000,Hunan,China)

机构地区：[1]广州市第八人民医院病理科,广东广州510000 [2]广州市第八人民医院外科,广东广州510000 [3]湖南医药学院,湖南怀化418000

出　　处：《医学信息》2018年第20期45-48,共4页Journal of Medical Information

基　　金：2013年湖南省教育厅教学改革研究项目(编号:625)

摘　　要：目的探讨艾滋病患者阑尾炎病理分型特点及与临床手术方式选择的关系。方法将2013年3月～2018年3月在广州市第八人民医院外科住院治疗的37例急性阑尾炎合并艾滋病患者设为实验组,选取同期同科室治疗的非HIV感染阑尾炎患者50例设为对照组,比较两组病理类型、临床表现和手术方式等方面特点。结果与非HIV感染患者相比较,艾滋病患者急性阑尾炎病理类型包括急性化脓性阑尾炎、急性坏疽性阑尾炎、结核,马尔尼菲蓝状菌病,巨细胞性病毒性肠炎;其中结核,马尔尼菲蓝状菌病,巨细胞病毒性肠炎发病率高于非HIV患者,差异有统计学意义(P<0.05),在艾滋病患者中,导致患者腹腔镜手术中转开腹的主要病理类型包括结核、马尔尼菲蓝状菌病和急性坏疽性阑尾炎。结论艾滋病患者急性阑尾炎病理类型包括急性化脓性阑尾炎、急性坏疽性阑尾炎、结核、马尔尼菲蓝状菌病、巨细胞病毒性肠炎;其中结核、马尔尼菲蓝状菌病和急性坏疽性阑尾炎等是艾滋病患者LA中转开腹的主要病理类型;术前建立合理的评判标准有助于减少中转开腹可能。Objective To investigate the pathological classification of appendicitis in AIDS patients and its relationship with clinical surgical methods.Methods 37 patients with acute appendicitis and AIDS who were hospitalized in the Eighth People＇s Hospital of Guangzhou from March 2013 to March 2018 were enrolled in the experimental group,50 patients with non-HIV-infected appendicitis treated with the same department were selected as the control group,and the pathological types,clinical manifestations and surgical methods were compared.Results Compared with non-HIV infected patients,the pathological types of acute appendicitis in AIDS patients included acute suppurative appendicitis,acute gangrenous appendicitis,tuberculosis,Marnifi blue blast disease,cytomegalovirus enteritis;Among them,the incidence of tuberculosis,Marnifi blue blast disease,cytomegalovirus enteritis was higher than that of non- HIV patients,the difference was statistically significant （P〈0.05）.Among AIDS patients,the main pathological types that lead to conversion to laparotomy in patients undergoing laparoscopic surgery include tuberculosis,Marnifi blue blast disease,and acute gangrenous appendicitis.Conclusion The pathological types of acute appendicitis in AIDS patients include acute suppurative appendicitis,acute gangrenous appendicitis,tuberculosis,Marnifi blue blast disease,and cytomegalovirus enteritis;among them, tuberculosis,Marnifi blue blast disease,and acute gangrenous appendicitis are the main pathological types of AIDS patients with LA conversion to open surgery;establishing a reasonable evaluation criteria before surgery can help reduce the possibility of conversion to open surgery.

关 键 词：人类免疫缺陷病毒 阑尾切除术 腹腔镜检查 中转开腹 阑尾炎 结核 马尔尼菲蓝状菌 巨细胞病毒 

分 类 号：R656.8[医药卫生—外科学] R512.91[医药卫生—临床医学]