12例急性阑尾炎合并肠梗阻的临床分析

Analysis of the diagnosis and therapy of acute appendicitis with intestine obstruction

目的探讨表现为肠梗阻的阑尾炎的临床规律。方法收集以肠梗阻为临床表现的阑尾炎病例的临床资料并回顾性分析其临床和解剖学特点。结果在术后诊断为急性化脓性阑尾炎的182例患者中，以肠梗阻收住入院的有12例，这12例病人就诊前病程3—5d，12例病人回盲部周围炎症均严重，伴有回盲部水肿，回肠后位阑尾6例。结论以肠梗阻为临床表现的不典型阑尾炎术前常常不易确诊，早期即有体温和血象升高的肠梗阻应警惕阑尾炎；及时手术探查有助于正确诊断和治疗；回肠后位阑尾的炎症容易波及回盲瓣而引起肠梗阻。

Objective To discuss the clinic features of acute appendicitis resulting intestine obstruction. Methods We retrospectively analyzed the clinical and anatomic features of those acute purulent appendicitis resulting intestine obstruction. Results Among the 182 acute appendicitis patients diagnosed after operation, 12 presented symptom of intestine obstruction, these 12 patients has longer disease history more than 3 days with ileocecal junction swollen ,6 of them lies posterior of ileum. Conclusion The appendicitis with intestine obstruction is difficult to decide, and ease to misjudgment, early operation is helpful for correct diagnosis and therapy, ileum posterior appenditis is ease to cause intestine obstruction .