老年人急性阑尾炎276例诊治分析

目的探讨老年人急性阑尾炎早期诊断、外科治疗的临床效果及预后。方法回顾性分析276例老年急性阑尾炎外科治疗的临床资料,分析其易患因素、诊断方法、手术疗效及预后。结果276例死亡7例（2．5％）。术后6—8d拆线,平均住院时间8d。切口甲级愈合196例（71．0％）,乙级愈合43例（15．6％）,丙级愈合37例（13．4％）。术中证实阑尾穿孔86例（31．2％）,阑尾周围脓肿7例（2．5％）。伴发病76例次,术后早期并发症87例次,切口和腹腔内感染性并发症39例（14．1％）。结论早期诊断、及时手术、合理有效处理伴发病和并发症,是提高老年人急性阑尾炎手术疗效和预后的关键。

Analysis on early diagnosis and treatment of 276 cases with acute appendicitis in elderly

Objective To investigate early diagnosis, clinical effect of surgical treatment and prognosis of a-cute appendicitis in elderly. Methods The clinical data of acute appendicitis in elderly undergoing surgical therapy between January 1994 and November 2008 was analyzed retrospectively, and predisposing factors, diagnostic meth-ods, therapeutic effect of operation and prognosis were studied. Results Acute appendicitis in elderly was diagnosed in 276 cases(114 female/162 male). There were 7 cases of deaths. MoRality was 2.5% (7/276). Stitches were taken out from 6 to 8 days after operation. Average stay was 8 days. 196 cases(71.0%) of wound healing at grade A, 43 cases(15.6%) at grade B ,37 cases(13.4%) at grade C. 86 cases(31.2%) with perforated acute appendici-tis, and 7 cases(2.5%) with periappendiceal abscess were confirmed after operation. 76 cases auompanied with con-comitant diseases, 87 cases auompanied with postoperative early complications, and 39 cases(14.1%) with postop-erative wound or intra-abdominal septic complications. Conclusion Key point of improvement of operative therapeu-tic effect and prognosis of acute appendicitis in elderly are early diagnosis, operation in time, and effective treatment of associated diseases and complications.