超声定位在微小切口阑尾切除术前的临床应用

Value of Preoperative Ultrasound Localization in Small Incision Appendectomy

目的探讨超声定位体表标记法在微小切口阑尾切除术前的临床应用价值。方法选取58例经超声检查已明确显示病变阑尾的患者,在超声探测下于腹壁相应体表投影位置标记阑尾整体形态,切口范围限定于阑尾的体表投影处,将超声定位结果与术中探查结果相比较。结果超声诊断急性阑尾炎58例,术前超声对病变阑尾的定位均与术中探查结果相符。其中,回盲前位18例,盆位12例,盲肠后位10例,盲肠下位8例,回盲后位7例,异位阑尾3例。术前超声定位使微小切口阑尾切除术操作方便,明显缩短了术中寻找阑尾的时间,患者出血少,术后恢复快。结论术前超声定位为症状典型和非典型急性阑尾炎诊断及外科处理提供了客观的影像依据,有助于手术医师在微小切口阑尾切除术中快速找到阑尾,顺利完成手术。

Objective To explore the clinical application of ultrasonic localization in small incision appendectomy. Methods In 58 patients who suffered from acute appendicitis and underwent ultrasonic diagnosis, ultrasonography was used again to confirm the location of the inflamed appendix, the projection was drawn on abdominal wall. The incision area was limited the projection surface of appendix. The ultrasonic location was comparing with the surgical finding. Results All the 58 patients were diagnosed to have appendicitis by ultrasound, and the preoperative localization of the diseased appendix by ultrasound coincided totally with the findings by surgery. The demonstration of appendicitis that is in the different position as followed. 18 cases of prepositional ileum, 12 cases of appendicitis are in the pelvic cavity, 10 cases of cecitis made a backward movement, 8 cases of cecitis tenesmus, 7cases of ileum made a backward movement and 3 cases of ectopic appendix. During the operation, it was easy and quick to find the appendix, thus greatly shortening the operative time. The patients had less blood loss and recovered within a shorter time. Conclusions For patients with typical or atypical acute appendicitis, ultrasonic localization provides both diagnosis of diseased appendix and an imaging guide for surgery before operation, the latter helps surgeon complete appendectomy smoothly and rapidly.