阑尾手术扩大回盲部切除44例临床分析

目的：探讨阑尾手术扩大回盲部切除术的指征，为临床外科提供治疗经验。方法：回顾性研究1999—2008年在不同情况下1期施行的阑尾疾病扩大性回盲部切除术共44例，对其术中情况、手术方法、病理类型、疗效进行分析，与同期手术治疗的78例复杂性阑尾切除术进行比较。结果：44例1期施行的回盲部切除术患者均在术后2周内痊愈出院，手术并发症发生率为6．81％。而对照组因肠梗阻、腹腔残余脓肿、肠瘘、回盲部或阑尾肿块而行2次手术者达18例，并发症发生率为23．08％，明显高于回盲部切除术组（P〈0．01）。结论：阑尾疾病合并小肠梗阻、盲肠壁裂口、阑尾或回盲部性质不明肿块等是施行回盲部切除术的主要指征，可明显减少术后并发症。

Investigation of indications of ileocecectomy in surgical management of appendicle diseases

Objective:To determine indications of ileocecectomy in the surgical management of appendicle diseases and find evidence for clinical treatment.Methods:Data of 122 patients with appendicle diseases who underwent operative surgery from 1999 to 2008 were studied retrospectively,including 44 cases of phase I ileocectomy due to appendicle diseases of non-appendicitis(Group A)and 78 cases of appendectomy due to complex appendicitis(Group B).Surgical approaches,findings in surgery,pathology and effects of treatment of them were analyzed and compared.Results:Forty-four patients of group A who underwent phase I ileocectomy were cured with 6.81% complications and discharged in 14 days.Of the patients in group B,18 cases underwent re-operation due to intestinal obstruction,abdominal abscess,fistula,appendicle or ileocecal lumps,the incidence of complications was 23.08%.Compared the two groups for complication,there was significant difference(P<0.01).Conclusion:Ileocecectomy indicates predominantly to patients with inconclusive serious appendicle diseases and/or ordinary appendicle diseases coexisted with intestinal obstruction,cecal wall fissure,appendicle or ileocecal lump,with advantage of significantly lower complications.