结肠镜下取石联合药物治疗粪石梗阻型阑尾炎的研究

Treatment of Fecalith Obstructive Appendicitis Under Endoscopy Combined with Medication

目的研究内镜下清理粪石治疗阑尾炎的实用性和有效性。方法对2008年1月至2012年9月中山市陈星海医院通过右下腹彩超诊断粪石梗阻型阑尾炎患者76例,随机分为两组,每组38例,试验组实施经结肠镜下行粪石取出术,术后给予静脉使用左氧氟沙星(0.4g/d,3 d)联合甲哨唑(0.5g/d,3d)治疗,对照组采用常规内科治疗给予静脉使用左氧氟沙星(0.4g/d,3d)联合甲哨唑(0.5g/d,3d)治疗。观察患者治疗效果。结果内镜下治疗联合药物治疗效果明显,症状明显改善且未见并发症发生,试验组平均疗程(2.8±1.1)d,对照组平均疗程(7.2±1.8)d,两组比较,差异具有统计学意义,而且两种方法的疗效差异有统计学意义。结论内镜下治疗联合药物治疗粪石梗阻型阑尾炎效果明显,较单纯药物治疗组相比有明显统计学差异,对于不愿意手术治疗的患者采取此方法较单纯内科保守治疗效果为佳。

Objective To discuss the effectiveness and safety of fecalith obstructive appendicitis（FOA） under endoscopy. Methods From Jan. 2008 to Sep. 2012,76 Patients with FOA diagnosed by Color Doppler at Chenxinghai Hospital in Zhongshan City were divided into two groups,38 cases in each group. ＇[＇he trial group were treated with eodoseopic retrncatheterism appendixgraphy（ ERA（, ）, and their fecalith was taken out, and then levnfloxaein （ 0.4 g/d 3 d ） and metronidazole （ 0.5 g/d,3 d ） treatment intravenously. The control group were given conventional medical treatment of levofloxacin （0.4 g/d 31） and metronidazole （0.5 g/d, 3d） treatment intravenously. Results Endoscopic treatment combined with medication therapy were more effective, individual symptoms were improved significantly and no complications occurred, The average treat- ment duration of the trial group was（2.8 ＋ 1.1 ） d, of the control group was （7.2 _＋ 1.8 ） d,which was statis- tically significantly different, and the efficacy of the two methods had statistically significant difference. Conclusion Endoscopic therapy combined with medication treatment of appendicitis of stercoral obstruction has obvious effect compared with the simple medication treatment group, which has great significance for patients not willing to receive operation treatment,as a good choice for better therapeutic effect.