刘涛

【中图分类号】R656.8 【文献标识码】B 【文章编号】1672－3783(2011)07－0014－02

【摘要】目的：总结Ⅰ期阑尾切除术治疗急性阑尾炎合并阑尾周围脓肿的可行性、优点，为打破传统的保守治疗观念进行探索性尝试。方法：通过对本院2010年2月-2011年6月诊治的18例急性阑尾炎合并阑尾周围脓肿患者行Ⅰ期阑尾切除的临床资料进行回顾分析。结果：18例患者均实施Ⅰ期阑尾及脓肿切除术，术后未出现切口感染、早期炎性肠梗阻及肠瘘等并发症，平均住院8.24d。结论：恰当的手术方法可作为急性阑尾炎合并阑尾周围脓肿Ⅰ期阑尾切除的可行性选择，其具有缩短病程，降低医疗费用，安全可靠，值得临床推广运用。

【关键词】阑尾周围脓肿；Ⅰ期手术治疗；可行性研究

Acute appendicitis Appendiceal abscess combined Phase Ⅰ appendectomy experience Liu Tao

【Abstract】Objective: Phase Ⅰ appendectomy for acute appendicitis appendix abscess merger feasibility, advantages, to break the traditional conservative treatment of the concept of exploratory attempt. Methods: The hospital in February 2010 June 2011 diagnosis and treatment of 18 cases of acute appendicitis combined appendix abscess appendectomy in patients with stage Ⅰ clinical data were analyzed retrospectively. Results: 18 patients were stage Ⅰ appendectomy and abscess implementation of resection, postoperative wound infection does not appear, the early inflammatory intestinal obstruction and fistula and other complications, average length of stay 8.24d. Conclusion: The appropriate surgical approach can be combined as acute appendicitis appendix abscess stage Ⅰ viable option for appendectomy, its has a shorter duration and lower medical costs, safe, reliable, worthy of clinical use.

【Keywords】appendix abscess; Ⅰ surgical treatment; feasibility study

目前，多数医院对于阑尾脓肿的治疗仍采取药物保守治疗，只有当阑尾脓肿无局限趋势方考虑手术切开引流，而不强调Ⅰ期切除阑尾，3个月后再行阑尾切除术［1,2］。这无疑额外加重了患者的医疗费用、延长治疗时间、增加机体痛苦。特别是阑尾周围脓肿破溃后形成的各种并发症会给患者造成极大的麻烦。因此，对阑尾脓肿实施Ⅰ期切除术便成为学术界反复探讨的焦点［3］。2010年2月-2011年6月我院对18例急性阑尾炎合并阑尾周围脓肿患者行Ⅰ期阑尾切除取得良好的效果，未出现相关的并发症。现将有关情况汇报如下：

1资料与方法

1.1一般资料:本组18例患者，男性11例，女性8例，年龄为23-71岁，平均年龄为51.21岁。发病至就诊时间最短4d，最长12d，多数患者以上腹痛或脐周痛为首发临床表现，伴随明显转移性右下腹疼痛者仅6例。……