阑尾不同部位化脓性病变与并发门静脉炎的临床观察

The relationship between the Variety of Lesion Location of Suppurative Appendicitis and Portal Pylephlebitis

为分析阑尾不同部位化脓性病变与并发门静脉炎的关系，对３５年中收治的１６８３例急性化脓及坏疽性阑尾炎患者进行了回顾性分析。其中有２５例并发或术后出现门静脉炎或／和肝脓肿。经术中肉眼观察，阑尾远端病变５２７例，２例（０．３７％）并发或术后出现门静脉炎或／和肝脓肿；中远端病变８４０例，６例（０．７１％）并发或术后出现门静脉炎或／和肝脓肿；近端病变（阑尾整个病变）３１６例，１７例（５．３７％）并发或术后出现门静脉炎或／和肝脓肿。２５例门静脉炎或／和肝脓肿中１６例是在切除阑尾手术后才出现寒颤、高热等门静脉炎症状的。本组资料表明，阑尾近端的化脓性病变较之中。

To analyze the relationship between the pyogenic infection at different site of appendix and the occurrence of portal pylephlebitis, the author retrospectively analysed 1683 patients with acute suppurative and/or gangrenous appendicitis. Of them, 25 patients complicated portal pylephlebitis (PP) or liver abscesses (LA). Two of 527 cases whose infection located at the terminal appendix segment had PP or LA. Six of 840 cases whose infection located at the middle appendix segment complicated with PP or LA. Seventeen of 316 cases whose infection located at the proximal appendix segment complicated with PP or LA. In this series, 16 patients with PP or LA appeared chill and high fever postoperatively. The results suggest that PP and/or LA are predisposed to occur in the patients whose infection located at the proximal segment of appendix.