Schistosomal appendicitis(SA)is a rare but serious complication of schistosomiasis,a parasitic disease affecting over 250 million people worldwide.A recent retrospective study by Wang et al provides important insights...Schistosomal appendicitis(SA)is a rare but serious complication of schistosomiasis,a parasitic disease affecting over 250 million people worldwide.A recent retrospective study by Wang et al provides important insights into the clinicopathological characteristics of SA.The study compared 136 cases of SA to 5418 cases of non-SA over a ten-year period.Key findings include a higher average age of SA patients(61.73 years vs 35.8 years for non-SA),a higher proportion of acute on chronic appendicitis(33.1%vs 16%),and a significantly higher incidence of colorectal cancer(11.7%vs 2.2%).Despite these differences,SA remains a diagnostic challenge due to its nonspecific clinical presentation and lack of specific laboratory findings.The study also highlights the persistent prevalence of SA,accounting for 1.6%-3.4%of all appendicitis cases each year from 2013 to 2023.These findings underscore the need for enhanced awareness,early detection,and prompt treatment of SA in endemic regions.Given the association with colorectal cancer,patients with SA require thorough screening and follow-up.Further research into the pathogenesis and diagnostic markers of SA is warranted.As the global battle against schistosomiasis continues,targeted efforts to diagnose and manage SA can significantly improve patient outcomes.展开更多
BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases,especially the digestive system.Schistosome eggs are mainly deposited in the stomach,liver and colorectal,but a few eggs are deposi...BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases,especially the digestive system.Schistosome eggs are mainly deposited in the stomach,liver and colorectal,but a few eggs are deposited in the appendix and cause disease.At present,there are few studies on schistosomal appendicitis.AIM To explore the differences in epidemiological,clinical and pathological characteristics between schistosomal appendicitis and non-schistosomal appendicitis over the past decade in order to assess the impact of schistosomiasis on appendicitis.METHODS The differences of general data,clinical data and laboratory examination data of patients with appendicitis from October 2013 to October 2023 were retrospectively analyzed.All patients were divided into two groups for analysis.There were 136 patients in schistosomal appendicitis group and 5418 patients in non-schistosomal appendicitis group.RESULTS Schistosomal appendicitis accounted for 2.45%of all patients with appendicitis,and the annual proportion in the past decade was 2.2%,2.9%,1.8%,1.9%,3.4%,3.1%,1.9%,1.6%,3%,2.6%,respectively.The prevalence of schistosomal appendicitis was middle-aged and elderly males,with an average age of 61.73±15.335 years.The main population of non-schistosomal appendicitis was middle-aged men,with an average age of 35.8±24.013 years(P<0.001).The distribution of pathological types of appendicitis was different between the two groups(P<0.001).The incidence of acute suppurative appendicitis in non-schistosomal appendicitis was higher than that in schistosomal appendicitis[odds ratio(OR)=0.504;95%confidence interval(CI):0.349-0.728;P<0.001].The proportion of acute attack of chronic appendicitis in schistosomal appendicitis was higher than that in non-schistosomal appendicitis(OR=2.614;95%CI:1.815-3.763;P<0.001).The proportion of schistosomal appendicitis patients complicated with colorectal cancer was higher than that of nonschistosomal appendicitis patients(OR=5.087;95%CI:1.427-18.132;P=0.012).There was no difference in clinical symptoms between the two groups.In the laboratory examination,there was a significant difference in white blood cells between schistosomal appendicitis and non-schistosomal appendicitis.The level of white blood cells in schistosomal appendicitis group was slightly higher than the upper limit of the normal range.Other statistically significant indicators were in the normal range.CONCLUSION Schistosomal appendicitis is a severe condition that is often associated with intestinal malignancies,potentially leading to a poor prognosis.Schistosomal appendicitis is more likely to be misdiagnosed and missed diagnosed in clinical work because of its nonspecific clinical manifestations and laboratory examination.It is crucial to differentiate schistosomal appendicitis in middle-aged and elderly male patients presenting with appendicitis,and to ensure early detection and treatment.展开更多
目的探讨在急性阑尾炎患儿诊断中,超声征象的特点及诊断意义。方法以81例急性阑尾炎患儿为研究对象,将81例急性阑尾炎患儿依病理检测结果分为2组:进展性阑尾炎患儿34例(41.98%),单纯性阑尾炎患儿47例(58.02%)。通过超声检测的间接征象...目的探讨在急性阑尾炎患儿诊断中,超声征象的特点及诊断意义。方法以81例急性阑尾炎患儿为研究对象,将81例急性阑尾炎患儿依病理检测结果分为2组:进展性阑尾炎患儿34例(41.98%),单纯性阑尾炎患儿47例(58.02%)。通过超声检测的间接征象、直接征象,以及病理检查资料,并借助ROC曲线分析超声征象联合应用的曲线下面积(area under curve,AUC),进行综合分析,对患儿超声检查结果进行评分。结果进展组患儿超声检测的管壁连续性中断/层次清晰度不高、管腔积液、阑尾周围或腹腔积液、阑尾周围高回声、盲肠、回肠壁增厚检出率均高于单纯组(P<0.05);进展组超声间接征象、直接征象、联合征象评分均高于单纯组(P<0.05);ROC(receiver oprating characteristic)曲线下,联合征象诊断灵敏度、特异度、阳性预测值和阴性预测值分别为98.77%、97.53%、98.77%、96.30%均高于间接征象、直接征象,AUC为0.902高于间接征象、直接征象(P<0.05)。结论超声检测征象联合诊断,能够为急性阑尾炎患儿的早期诊断提供客观证据,且还可实现对疾病动态监测,从而有利于临床治疗方案的制定。展开更多
目的两种阑尾插管方法在内镜逆行阑尾炎治疗术中的应用比较。方法100例急性非复杂性阑尾炎患者随机分为弓刀组(50例)与导管组(50例),弓刀组采用乳头括约肌切开刀配合导丝阑尾插管,辅助内镜逆行阑尾炎治疗术,导管组采用造影导管配合导丝...目的两种阑尾插管方法在内镜逆行阑尾炎治疗术中的应用比较。方法100例急性非复杂性阑尾炎患者随机分为弓刀组(50例)与导管组(50例),弓刀组采用乳头括约肌切开刀配合导丝阑尾插管,辅助内镜逆行阑尾炎治疗术,导管组采用造影导管配合导丝阑尾插管,辅助内镜逆行阑尾炎治疗术。比较两组阑尾插管成功率、阑尾插管时间、手术时间、住院天数、腹痛消失时间、麦氏点压痛消失时间、白细胞复常时间、中性粒细胞百分比复常时间、阑尾炎复发率及手术并发症发生率。结果弓刀组阑尾插管时间短于导管组阑尾插管时间[6.00(4.15~7.45)min vs 8.65(6.08~11.23)min,P<0.001],弓刀组手术时间短于导管组手术时间[(47.51±10.70)min vs(55.96±12.21)min,P<0.001]。弓刀组阑尾插管成功率100%高于导管组阑尾插管成功率88%(P<0.05)。两组住院天数、腹痛消失时间、麦氏点压痛消失时间、白细胞复常时间、中性粒细胞百分比复常时间、阑尾炎复发率及手术并发症发生率比较无差异。结论乳头括约肌切开刀辅助阑尾插管能提高内镜逆行阑尾炎治疗术阑尾插管成功率、缩短阑尾插管时间及手术时间,不增加手术并发症,安全有效,值得临床推广。展开更多
目的探讨腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)在小儿复杂肝下阑尾炎中的诊疗效果。方法选取我院2013年1月—2020年2月收治的40例肝下阑尾炎患儿为研究对象,依据手术方式的不同分为LA组(n=22)和OA组(n=18),比较两组患儿发病及手术...目的探讨腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)在小儿复杂肝下阑尾炎中的诊疗效果。方法选取我院2013年1月—2020年2月收治的40例肝下阑尾炎患儿为研究对象,依据手术方式的不同分为LA组(n=22)和OA组(n=18),比较两组患儿发病及手术时间、术中出血量、术后切口感染、腹腔残余感染及肠梗阻、术后24 h C-反应蛋白(CRP)、术后排气时间、住院时间及住院费用等情况。结果LA组19例在腹腔镜下完成手术,3例中转开腹;两组在术中出血量、术后24 h CRP、术后排气时间、住院费用方面比较,差异有统计学意义(P<0.05);而在手术时间、术后并发症及住院时间等方面比较无统计学差异(P>0.05);术前未确诊病例:LA组/OA组6/4(P>0.05),但有临床意义。结论腹腔镜手术诊治小儿复杂肝下阑尾炎是一种安全可行有效的微创方式,具有创伤小、出血少、并发症少,恢复快、经济实用等优势,值得在小儿腹部外科疑难复杂疾病的诊断和适应症明确的手术中广泛应用。展开更多
目的探讨加速康复外科(enhanced recovery after surgery,ERAS)在儿童复杂阑尾炎围手术期的应用效果。方法选取2020年1月至2023年1月于泉州市儿童医院行腹腔镜手术的复杂阑尾炎患儿248例,根据随机数字表法将其分为对照组和ERAS组,每组各...目的探讨加速康复外科(enhanced recovery after surgery,ERAS)在儿童复杂阑尾炎围手术期的应用效果。方法选取2020年1月至2023年1月于泉州市儿童医院行腹腔镜手术的复杂阑尾炎患儿248例,根据随机数字表法将其分为对照组和ERAS组,每组各124例。两组患儿均行腹腔镜阑尾切除术,对照组患儿围手术期施行传统治疗方案,ERAS组患儿采用基于ERAS理念的治疗方案。比较两组患儿的术后首次排气/排便时间、住院时间、视觉模拟评分法(visual analogue scale,VAS)评分、术后并发症发生情况及住院满意度。结果ERAS组患儿的术后首次排气/排便时间、住院时间均明显短于对照组,术后并发症总发生率、术后VAS评分均显著低于对照组,住院满意度显著优于对照组(P<0.05)。结论儿童复杂阑尾炎围手术期实施ERAS措施,可促进患儿术后早期康复,同时减轻术后疼痛,降低并发症发生率,提高住院满意度,值得临床推广应用。展开更多
文摘Schistosomal appendicitis(SA)is a rare but serious complication of schistosomiasis,a parasitic disease affecting over 250 million people worldwide.A recent retrospective study by Wang et al provides important insights into the clinicopathological characteristics of SA.The study compared 136 cases of SA to 5418 cases of non-SA over a ten-year period.Key findings include a higher average age of SA patients(61.73 years vs 35.8 years for non-SA),a higher proportion of acute on chronic appendicitis(33.1%vs 16%),and a significantly higher incidence of colorectal cancer(11.7%vs 2.2%).Despite these differences,SA remains a diagnostic challenge due to its nonspecific clinical presentation and lack of specific laboratory findings.The study also highlights the persistent prevalence of SA,accounting for 1.6%-3.4%of all appendicitis cases each year from 2013 to 2023.These findings underscore the need for enhanced awareness,early detection,and prompt treatment of SA in endemic regions.Given the association with colorectal cancer,patients with SA require thorough screening and follow-up.Further research into the pathogenesis and diagnostic markers of SA is warranted.As the global battle against schistosomiasis continues,targeted efforts to diagnose and manage SA can significantly improve patient outcomes.
文摘BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases,especially the digestive system.Schistosome eggs are mainly deposited in the stomach,liver and colorectal,but a few eggs are deposited in the appendix and cause disease.At present,there are few studies on schistosomal appendicitis.AIM To explore the differences in epidemiological,clinical and pathological characteristics between schistosomal appendicitis and non-schistosomal appendicitis over the past decade in order to assess the impact of schistosomiasis on appendicitis.METHODS The differences of general data,clinical data and laboratory examination data of patients with appendicitis from October 2013 to October 2023 were retrospectively analyzed.All patients were divided into two groups for analysis.There were 136 patients in schistosomal appendicitis group and 5418 patients in non-schistosomal appendicitis group.RESULTS Schistosomal appendicitis accounted for 2.45%of all patients with appendicitis,and the annual proportion in the past decade was 2.2%,2.9%,1.8%,1.9%,3.4%,3.1%,1.9%,1.6%,3%,2.6%,respectively.The prevalence of schistosomal appendicitis was middle-aged and elderly males,with an average age of 61.73±15.335 years.The main population of non-schistosomal appendicitis was middle-aged men,with an average age of 35.8±24.013 years(P<0.001).The distribution of pathological types of appendicitis was different between the two groups(P<0.001).The incidence of acute suppurative appendicitis in non-schistosomal appendicitis was higher than that in schistosomal appendicitis[odds ratio(OR)=0.504;95%confidence interval(CI):0.349-0.728;P<0.001].The proportion of acute attack of chronic appendicitis in schistosomal appendicitis was higher than that in non-schistosomal appendicitis(OR=2.614;95%CI:1.815-3.763;P<0.001).The proportion of schistosomal appendicitis patients complicated with colorectal cancer was higher than that of nonschistosomal appendicitis patients(OR=5.087;95%CI:1.427-18.132;P=0.012).There was no difference in clinical symptoms between the two groups.In the laboratory examination,there was a significant difference in white blood cells between schistosomal appendicitis and non-schistosomal appendicitis.The level of white blood cells in schistosomal appendicitis group was slightly higher than the upper limit of the normal range.Other statistically significant indicators were in the normal range.CONCLUSION Schistosomal appendicitis is a severe condition that is often associated with intestinal malignancies,potentially leading to a poor prognosis.Schistosomal appendicitis is more likely to be misdiagnosed and missed diagnosed in clinical work because of its nonspecific clinical manifestations and laboratory examination.It is crucial to differentiate schistosomal appendicitis in middle-aged and elderly male patients presenting with appendicitis,and to ensure early detection and treatment.
文摘目的探讨在急性阑尾炎患儿诊断中,超声征象的特点及诊断意义。方法以81例急性阑尾炎患儿为研究对象,将81例急性阑尾炎患儿依病理检测结果分为2组:进展性阑尾炎患儿34例(41.98%),单纯性阑尾炎患儿47例(58.02%)。通过超声检测的间接征象、直接征象,以及病理检查资料,并借助ROC曲线分析超声征象联合应用的曲线下面积(area under curve,AUC),进行综合分析,对患儿超声检查结果进行评分。结果进展组患儿超声检测的管壁连续性中断/层次清晰度不高、管腔积液、阑尾周围或腹腔积液、阑尾周围高回声、盲肠、回肠壁增厚检出率均高于单纯组(P<0.05);进展组超声间接征象、直接征象、联合征象评分均高于单纯组(P<0.05);ROC(receiver oprating characteristic)曲线下,联合征象诊断灵敏度、特异度、阳性预测值和阴性预测值分别为98.77%、97.53%、98.77%、96.30%均高于间接征象、直接征象,AUC为0.902高于间接征象、直接征象(P<0.05)。结论超声检测征象联合诊断,能够为急性阑尾炎患儿的早期诊断提供客观证据,且还可实现对疾病动态监测,从而有利于临床治疗方案的制定。
文摘目的两种阑尾插管方法在内镜逆行阑尾炎治疗术中的应用比较。方法100例急性非复杂性阑尾炎患者随机分为弓刀组(50例)与导管组(50例),弓刀组采用乳头括约肌切开刀配合导丝阑尾插管,辅助内镜逆行阑尾炎治疗术,导管组采用造影导管配合导丝阑尾插管,辅助内镜逆行阑尾炎治疗术。比较两组阑尾插管成功率、阑尾插管时间、手术时间、住院天数、腹痛消失时间、麦氏点压痛消失时间、白细胞复常时间、中性粒细胞百分比复常时间、阑尾炎复发率及手术并发症发生率。结果弓刀组阑尾插管时间短于导管组阑尾插管时间[6.00(4.15~7.45)min vs 8.65(6.08~11.23)min,P<0.001],弓刀组手术时间短于导管组手术时间[(47.51±10.70)min vs(55.96±12.21)min,P<0.001]。弓刀组阑尾插管成功率100%高于导管组阑尾插管成功率88%(P<0.05)。两组住院天数、腹痛消失时间、麦氏点压痛消失时间、白细胞复常时间、中性粒细胞百分比复常时间、阑尾炎复发率及手术并发症发生率比较无差异。结论乳头括约肌切开刀辅助阑尾插管能提高内镜逆行阑尾炎治疗术阑尾插管成功率、缩短阑尾插管时间及手术时间,不增加手术并发症,安全有效,值得临床推广。
文摘目的探讨腹腔镜阑尾切除术(LA)与开腹阑尾切除术(OA)在小儿复杂肝下阑尾炎中的诊疗效果。方法选取我院2013年1月—2020年2月收治的40例肝下阑尾炎患儿为研究对象,依据手术方式的不同分为LA组(n=22)和OA组(n=18),比较两组患儿发病及手术时间、术中出血量、术后切口感染、腹腔残余感染及肠梗阻、术后24 h C-反应蛋白(CRP)、术后排气时间、住院时间及住院费用等情况。结果LA组19例在腹腔镜下完成手术,3例中转开腹;两组在术中出血量、术后24 h CRP、术后排气时间、住院费用方面比较,差异有统计学意义(P<0.05);而在手术时间、术后并发症及住院时间等方面比较无统计学差异(P>0.05);术前未确诊病例:LA组/OA组6/4(P>0.05),但有临床意义。结论腹腔镜手术诊治小儿复杂肝下阑尾炎是一种安全可行有效的微创方式,具有创伤小、出血少、并发症少,恢复快、经济实用等优势,值得在小儿腹部外科疑难复杂疾病的诊断和适应症明确的手术中广泛应用。
