摘要
目的讨论异位阑尾炎的临床特点与诊断。方法通过回顾我院2007年2月至2012年8月收治的43例异位阑尾炎患者的治疗过程,总结异位阑尾炎的临床特点与诊断经验。结果 43例患者在术前明确诊断为异位阑尾炎患者9例,4例患者疑似异位阑尾炎,分别占患者比例为20.9%和9.3%。其余30名患者诊断为急性胃肠炎、尿路结石、盆腔炎、胆囊炎、上消化道穿孔等;13例患者均于右下腹麦氏点行阑尾炎手术,其余30例行剖腹探查切口;手术时间45～200min,平均(78±22)min;住院时间5～14d,平均住院(7.3±2.1)d,所有患者均成功出院。经术后病理证实:单纯新阑尾炎7例,坏疽、穿孔性阑尾炎15例,化脓性阑尾炎21例。治疗中,共5例患者出现术后并发症,其中:切口感染及脂肪液化4例,早期炎性肠梗阻1例。经对症治疗,并发症消失或缓解。结论异位阑尾炎在诊断中容易出现误诊,需要不断提高医师的临床诊断经验,提高诊断准确度。
Objective To discuss the clinical features and diagnosis of ectopic appendicitis. Methods By retrospective analysis of 43 cases of ectopic appendicitis patients admitted to our hospital from February 2007 to August 2012, the clinical features and diagnosis experience of ectopic appendicitis were summarized. Results Among 43 cases of patients, 9 cases were preoperatively diagnozed clearly as ectopic appendicitis, 4 cases were diagnozed as suspected ectopic appendicitis, with the proportion accounting for 20.9% and 9.3% of all the patients respectively. The remaining 30 cases of patients were diagnozed as acute gastroenteritis, urinary tract stones, pelvic inflammatory disease, cholecystitis, upper gastrointestinal perforation; 13 cases of patients underwent appendicitis surgery at Maxwell point in the right lower quadrant, and the remaining 30 cases of patients underwen laparotomy incision; surgery time was 45 - 200 min, an average of （78± 22） min; hospital stay was 5 d - 14 d, the average hospital stay was （7.3 ± 2.1） d, all the patients were successfully discharged. Postoperative pathology confirmed 7 cases of pure new appendicitis, 15 cases of gangrenous and perforated appendicitis, 21 cases of suppurative appendicitis. In the cpurse of treatment, 5 cases of patients had postoperative complications, including 4 cases of incision infection and fat liquefaction, one case of early inflammatory intestinal obstruction. After symptomatic treatment, the complications disappeared or relieved. Conclusion Ectopic appendicitis is prone to misdiagnosis, so it is necessary for physicians to continue to increase the clinical experience, and to improve the diagnostic accuracy.
出处
《临床医学工程》
2013年第1期45-46,共2页
Clinical Medicine & Engineering
关键词
异位阑尾炎
临床特点
诊断
Clinical feature
Ectopic appendicitis
Diagnosis and treatment
