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目的探讨老年急性阑尾炎发病特点、诊断要点及外科治疗的临床体会。方法回顾性总结分析确山县第一人民医院自2005年1月至2011年12月施行手术治疗的76例老年人急性阑尾炎患者的临床资料。结果 76例患者均行手术治疗,其中单纯阑尾切除术52例,阑尾切除加腹腔引流术18例,单纯腹腔引流术6例。术后所有患者使用二联抗生素,并对其他症状对症处理,全组无腹腔内出血及残余脓肿形成,无粘连性肠梗阻及阑尾残株炎等发生。结论阑尾管腔阻塞和细菌感染是急性阑尾炎的主要发病机制,根据典型的症状、体征一般诊断并不困难,老年人阑尾炎一旦诊断明确,应尽早行外科手术治疗。
Objective To investigate the incidence of senile acute appendicitis, the main points of diagnosis and surgical treatment of clinical experience. Methods The clinical data of 76 elderly patients with acute appendicitis who underwent surgical treatment from January 2005 to December 2011 in First People’s Hospital of Queshan County were retrospectively analyzed. Results All the 76 patients underwent surgical treatment. Among them, 52 were simple appendectomy, 18 were appendectomy plus abdominal drainage and 6 were simple abdominal drainage. All patients were treated with two antibiotics, symptomatic treatment of other symptoms, no intra-abdominal bleeding and residual abscess formation, no adhesive intestinal obstruction and appendix stump inflammation. Conclusion Appendiceal lumen obstruction and bacterial infection are the main pathogenesis of acute appendicitis. According to the typical symptoms, the general diagnosis of signs is not difficult. Once the diagnosis of appendicitis in the elderly is clear, surgical treatment should be performed as soon as possible.