急性阑尾炎术前超声定位的临床应用及其价值

目的 探讨急性阑尾炎术前超声定位和体表标记法的临床应用及其价值。方法 选取68例经超声检查已明确显示病变阑尾的患者，在超声观察下用防水色笔描记阑尾在腹壁相应体表投影的整体形态，手术切口3cm限定于阑尾的体表投影处，将超声定位结果与手术病理检查结果相比较。结果 超声诊断急性阑尾炎68例，术前超声对病变阑尾的定位均与手术所见相符，其中阑尾盆位14例，盲肠下位13例，盲肠后位11例，回盲前位14例，回盲后位11例，异位阑尾5例。术前超声定位使阑尾切除手术操作方便，明显缩短了术中寻找阑尾的时间，患者出血少，术后恢复快。结论 术前超声定位为症状典型和非典型急性阑尾炎诊断及外科处理提供了客观的影像依据，有助于手术医师在阑尾切除术中快速找到阑尾顺利完成手术。

Preoperative localization of inflamed appendix by ultrasound in patients with acute appendicitis

Objective To evaluate the clinical application of ultrasonic localization of the inflamed appendix and its marking on the body surface in patients with acute appendicitis before operation. Methods In 68 patients who suffered from acute appendicitis and underwent ultrasonic diagnosis, ultrasonography was used again to confirm the location of the inflamed appendix, the projection of which was drawn on the abdominal wall with a color pen before operation. Then the operative incision of 3 cm was made exactly at the projection drawing of the appendix on the body surface. After operation the ultrasonic localization of the appendix was compared with that of the surgical and pathological findings. Results The diagnostic sensitivity of acute appendicitis by ultrasound was 89.47% (68/76). The preoperative localization of the diseased appendix by ultrasound coincided totally with the findings by surgery. During the operation, it was easy and quick to find the appendix, thus greatly shortening the operative time. The patients had less blood loss and recovered within a shorter time. Conclusions For patients with typical or atypical acute appendicitis, ultrasonic localization provides both diagnosis of the diseased appendix and an imaging guide for surgery before operation, the latter helps surgeon complete appendectomy smoothly and rapidly.