老年急性阑尾炎48例临床治疗体会

Clinical treatment experience of 48 cases of elderly patients with acute appendicitis

目的:总结老年急性阑尾炎治疗经验及临床疗效。方法:2012年8月-2014年1月收治老年阑尾炎患者48例,其中10例阑尾周围脓肿,应用抗生素治疗1周,症状未见好转,行脓肿切开引流术,坏疽性阑尾炎行急诊阑尾切除和腹腔引流术治疗,9例急性化脓性阑尾炎和28例急性单纯性阑尾炎行急诊阑尾切除手术治疗。结果:本组48例急性阑尾炎患者经过治疗,47例患者伤口愈合良好,1例并发糖尿病导致伤口感染,经换药后延迟愈合,经过2~6个月的随访,48例患者均无粘连性肠梗阻和腹腔内出血及残余脓肿形成。结论:老年人急性阑尾炎症状不典型,需要仔细检查,根据患者阑尾炎的具体情况来选择相应的治疗方法,才能达到较好的临床效果。

Objective:To sum up the treatment experience and clinical effect of patients with acute appendicitis.Methods:48patients with acute appendicitis were selected from August 2012 to January 2014.Among 10 cases of appendiceal abscess were treated by antibiotics for 1 week,but their symptoms had not been better,so they were treated by abscess incision drainage.The gangrenous appendicitis were given emergency appendectomy and peritoneal drainage treatment.9 cases of acute suppurative appendicitis and 28 cases of acute simple appendicitis were given emergency appendectomy operation treatment.Results:In 48 patients with acute appendicitis,the wound of 47 patients healed well,1 patient complicated with diabetes leaded to wound infection,and healed after dressing change.After 2~6 months follow-up.48 patients were free of adhesive ileus,intraperitoneal hemorrhage and residual abscess formation.Conclusion:Elderly patients with acute appendicitis have atypical symptoms,need careful examination.In order to achieve good clinical results,the corresponding treatment methods should be choosen according to the specific situation of patients with appendicitis.