老年性右半结肠癌并发急性阑尾炎18例临床分析

The Clinical Analysis of 18 Cases of Senile Right Colon Cancer with Acute Appendicitis

目的探讨老年性结肠癌并发急性阑尾炎误诊、漏诊原因及预防措施.方法回顾性分析昆明市延安医院2008年1月至2010年1月右半结肠癌并发急性阑尾炎18例的临床资料.结果本组18例右半结肠癌患者入院时均误诊为急、慢性阑尾炎或阑尾周围脓肿,最终经病理证实为结肠腺癌合并急性单纯阑尾炎.本组18例病例中失访3例;随访15例,随访率83.33%,95%可信区间为65.66%～87.94%,其中死亡3例.结论右半结肠癌本身临床表现不典型,与急性阑尾炎并存易误诊、漏诊,因此仔细询问病史和体格检查,以及行相关的辅助检查、术中对盲肠、升结肠进行探查是减少漏诊误诊的关键.

Objective To investigate the misdiagnosis causes and preventive measures of senile right colon cancer with acute appendicitis.Method Retrospective study was used to analyze the experience of 18 cases of senile right colon cancer with acute appendicitis in Kunming Yan＇an Hospital from January 2008 to January 2010.Result 18 patients with right colon cancer were misdiagnosed as acute and chronic appendicitis or appendix abscess on admission,and were confirmed as colon cancer with acute simple appendicitis by pathological examination.Conclusion Right colon cancer has no typical clinical manifestations and is easily misdiagnosed because it often complicated with acute appendicitis,so it is critical to reduce the misdiagnosis rate by learning the history carefully,taking physical examination and laboratory examinations,and exploring the cecum and ascending colon during operation.