腹腔镜手术术前误诊为阑尾炎12例分析

The Analysis of 12 Cases in Which Patients Are Misdiagnosed as Appendicitis Before Laparoscopic Operation

目的探讨腹腔镜技术在阑尾炎诊断治疗过程中的价值与优势,以减少因术前误诊对病人造成的额外创伤。方法回顾我科2011年12月至2012年11月共施行腹腔镜阑尾切除手术143例的临床资料,其中误诊12例;对患者的病史、辅助检查结果以及手术情况进行回顾性分析。结果所有12例病人术前均误诊为阑尾炎,术中腹腔镜探查及时修正诊断,行相应手术处理,手术后均痊愈出院。结论有些疾病临床表现酷似阑尾炎,依靠病史、体征及常规辅助检查较难鉴别,而腹腔镜手术能够很好地探查腹腔,及时明确诊断,避免因术前误诊导致误切阑尾而遗漏真正病变,减少对病人造成的额外创伤。

Objective To explore the value and advantage of laparoscopy in the diagnosis and treatment of appendicitis, so as to reduce additional trauma that caused by misdiagnosis before operation. Methods The clinical data of 143 patients who underwent laparoscopic appendectomy from Dec. 2011 to Nov. 2012 was reviewed, in which 12 cases were misdiagnosed. Retrospective analysis was made of the patient＇s clinical history, auxiliary examination results and operation situation. Results All the 12 patients were misdiagnosed as appendicitis before operation, and reassessed by laparoscopy and given corresponding treatment in the operation, then successfully cured and all discharged from hospital after, opera- lion. Conclusion The clinical manifestation of some diseases is quite similar to appendicitis, so it is difficult to differentiate them only by clinical history, signs and routine auxiliary examination. However, laparoscopic surgery can perform a sound detection to the abdominal cavity and a timely diagnosis, which can avoid appendix being cut by mistake and the real lesions being missed due to preoperative misdiagnosis, and eventually reduce the additional trauma to the patients.