78例非典型性急性阑尾炎的临床分析

Clinical analysis of acute atypical appendicitis

目的探讨非典型性急性阑尾炎发病机理,临床特点和诊治方法。方法回顾性分析笔者所在医院2007年8月～2011年8月经手术确诊的78例非典型性急性阑尾炎患者的诊疗情况。结果 50例患者手术前初诊为腹痛原因待查,考虑为急性阑尾炎;28例患者手术前初诊为其他急腹症;全部患者手术后均证实是非典型急性阑尾炎。包括48例化脓性阑尾炎,17例坏疽性阑尾炎以及13例单纯性阑尾炎。10例出现术后并发症。结论充分了解非典型性急性阑尾炎的发病机制和临床特点,对该病的早期诊断及尽早治疗意义重大。无法确诊又不能排除急性阑尾炎的急腹症,尽快实行剖腹探查。

Objective To investigate the pathogenesis,clinical features,the methods of diagnosis and treatment of acute atypical appendicitis.Methods To review and analyze clinical data of 78 patients with acute atypical appendicitis who were confirmed by operation in the author＇s hospital.Results 50 cases were suspected with acute appendicitis and 28 cases were considered with other surgical abdomen.All patients were confirmed by pathological examination.Among them,48 cases were suppurative appendicitis,17 cases were gangrenous acute appendicitis and 13 cases were simple appendicitis.10 cases suffered from complication.Conclusion Fully understanding the etiopathogenesis and clinical manifestation is important for the early diagnosis and treatment of acute atypical appendicitis.Early exploratory laparotomy should be performed as soon as possible when these patients were not diagnosed and excluded from surgical abdomen.