27例阑尾周围脓肿保守治疗复发病例的临床特点

目的分析阑尾周围脓肿患者保守治疗后复发的临床特点,以期更为深入探讨阑尾周围脓肿的治疗方法和疗效。方法回顾患者首次症状和复发的病历及相关数据。包括一般流行病学数据,以及症状、体征和血分析白细胞计数。结果117例阑尾周围脓肿患者经过保守治疗,其中有27例(23.1%)因再次复发而入院。该部分病人的初次发作时白细胞计数平均为13.2,复发时平均为9.4。最高体温初次发作时平均为37.9°,复发时平均为37.0°。静脉抗生素在初次发作时平均使用6d(4～8d),在复发时平均使用4d(3～7d)。结论研究发现阑尾周围脓肿治疗后复发率较低,且复发时临床表现明显较轻。对于初次发作保守治疗症情解除后可以不必择期手术治疗,在复发时再行相应处理。

THE CLINICAL PRESENTATION OF RECURRENT PERIAPPENDICEAL ABSCESS IN 27 CASES

Objective Study the clinical presentation of recurrent periappendiceal abscess for more reasonable treatment algorithm.Methods We reviewed the patients' data from initial and recurrent episode,including age,gender,symptoms,physical signs and white blood cell count(WBC).The data also came from treatment course.Results 27 cases(23.1%)were readmitted for recurrence.The average WBC at initial episode recurrence was 13.2 while 9.4 at recurrence.The average maxim temperature was 37.9° at initial episode while 37° at recurrence.The average time for intravenous antibiotics use was 6 days at initial episode while 4 days at recurrence.ConclusionsThis study shows that the recurrence rate is relatively low and the presentation at recurrence is milder.It is not necessary to apply the interval appendectomy.