以肠梗阻症状为首发表现的阑尾炎30例临床分析

30 cases of clinical characteristics analysist of appendicitis patients with intestinal obstruction as the initial presentation

目的探讨以肠梗阻症状为首发表现的阑尾炎临床特征,提高临床诊断率。方法选择30例以肠梗阻症状为首发表现的急性阑尾炎患者作为观察组,选取30例不伴肠梗阻症状首发表现的急性阑尾炎患者为对照组,分别比较2组的年龄及首发临床表现。结果 〈8岁和〉60岁年龄段,观察组例数明显高于对照组,差别均有统计学意义（P〈0.05）;16~60岁年龄段,观察组例数明显低于对照组,差别有统计学意义（P〈0.05）;观察组发热、恶心呕吐、腹胀、肠鸣音消失及腹部气过水声患者例数明显高于对照组,差别有统计学意义（P〈0.05或0.01）。结论以肠梗阻为首发表现的不典型阑尾炎术前常常不易确诊,应详细询问病史,细致全面的体格检查,有助于减少肠梗阻症状为首发表现阑尾炎的误诊。

Objective To analysist the clinical characteristics of appendicitis patients with intestinal obstruction as the initial presentation. Methods In 39 cases of acute appendicitis patients with intestinal obstruction as the initial presentation were set as the observation group, who visited to the emergency department of our hospital and suspected acute intestinal obstruction, another 30 cases without intestinal obstruction as the initial presentation were set as the control group. Results The number of cases in the observation group was significantly higher than the control group at the age of 8 and 60 years（P 0.05）; The number of cases in the observation group was significantly lower than the control group at the age of 16~60 years（P 0.05） The number of cases of fever, nausea and vomiting, abdominal distention, bowel sounds disappeared and abdominal gurgling in the observation group was significantly higher than the control group（P 0.05 or 0.01）. Conclusion Appendicitis patients with intestinal obstruction as the initial presentation is often difficult to confirmed diagnosis in before surgery, a detailed history and thorough physical examination helps to reduce the rate of misdiagnosis of appendicitis with intestinal obstruction as the initial presentation.