58例老年糖尿病患者并发急性阑尾炎腹腔镜治疗的病例分析

The Analysis of Elderly Diabetic Patients with Laparoscopic Treatment of Acute Appendicitis

目的:探讨老年糖尿病并发急性阑尾炎患者临床特点及诊治要点。方法对我院2010年5月~2012年5月收治的58例老年糖尿病并发急性阑尾炎患者临床资料进行回顾性分析。结果患者围手术期控制血糖,50例手术患者者术中发现阑尾为化脓感染,其中13例坏疽或穿孔,单纯阑尾炎8例,术后13例切口感染,切口裂开1例,经换药后痊愈,2例术后出现麻痹性肠梗阻,经禁食、胃肠减压、禁食、补液等保守治疗后痊愈出院。结论老年糖尿病并发急性阑尾炎有其独到的特点,其阑尾炎坏疽及穿孔率较高,术后切口易感染,应早期诊断,积极手术,减少并发症的出现。

Objective To investigate clinicals features and treatment point of acute appendicitis in elderly diabetic patients.Methods 58 cases of elderly patients with diabetes treated acute appendicitis in clinical data were retrospectively analyzed.Results The perioperative glycemic control.50 cases were found purulent infection of the appendix in patients undergoing surgery,13 cases of gangrene or perforation,eight cases were simple appendicitis,13 cases of postoperative had wound infection,wound dehiscence in one case,by dressing after recovery.Two cases of postoperative paralytic ileus,who discharged after fasting,gastrointestinal decompression,fasting,fluid replacement and other conservative treatment.Conclusion The elderly diabetic acute appendicitis has its unique features,the higher gangrenous and perforated appendicitis rate,postoperative wound susceptible to infection,which should be early diagnosis,aggressive surgery,reduce complications.