急性阑尾炎手术治疗的临床体会

Surgical treatment of acute appendicitis clinical experience

目的：总结急性阑尾炎的临床特征及手术方法治疗的临床效果、体会。方法：选择本院2010年1月～2011年1月收治的56例急性阑尾炎（均行阑尾切除术）的患者临床资料进行回顾性分析。结果：56例急性阑尾炎患者经手术治疗后全部痊愈出院。但其中出现5例患者合并弥漫性腹膜炎者，在尽力吸尽脓液后要先用0．9％氯化钠溶液冲洗，然后再用0．5％灭滴灵冲洗并置管引流，同时存在合并局限性腹膜炎的患者，应在吸尽脓液后再用盐水纱布蘸净，但是不用作冲洗，不置引流。术后54例伤口一期愈合，2例切口感染经引流后二期愈合，感染后抗感染治疗最长7d痊愈。全组无腹腔内出血，无术后肠瘘、粘连性肠梗阻及阑尾残株炎发生。结论：急性阑尾炎比较容易被误诊，这样就要求根据患者的具体病史、临床症状以及特有体征尽量早诊断，根据不同患者情况选择合适的手术时机和手术方法进行阑尾切除治疗，同时要防止术后并发症的发生。

Objective： To summarize the clinical features of acute appendicitis and the clinical effects of surgical treatments and experience. Methods： From January 2010 to January 2011 in our hospital 56 cases of acute appendicitis treated （all lines appendectomy） of the patients were retrospectively analyzed. Results： 56 patients of acute appendicitis in all patients cured by surgery and discharged after treatment. But 5 cases with diffuse peritonitis in patients who were trying to exhaust pus washed with saline after the first, and then use the 0.5% metronidazole rinse and catheter drainage combined limitations exist in patients with peritonitis should be used after the exhaustion pus net gauze dipped in salt water, but not for irrigation, drainage and incredulous. Postoperative wound healing in 54 cases, 2 cases of wound infection after the second phase of healing by drainage, anti-itffection treatment after infection up to 7 days recovery. There was no intra-abdominal bleeding, no postoperative intestinal fistula, adhesive intestinal obstruction and phlebitis occurred in the appendix stump. Conclusion： Relatively easy to be misdiagnosed with acute appendicitis, so that the specific requirements based on the patient history, clinical symptoms and signs specific diagnosis as early as possible, depending on the patient to choose the appropriate timing of surgery and surgical methods of treatment appendectomy, at the same time to prevent postoperative the occurrence of disease.