老年急性阑尾炎诊治分析

目的：总结老年急性阑尾炎的临床表现特点及治疗方法，提高诊治水平。方法：回顾性分析武汉市第一医院急诊外科2011年1月-2013年1月接诊的67例老年阑尾炎患者的临床资料。结果：手术治疗54例（80．60％），非手术治疗13例（19．40％），全部治愈。手术患者病检结果中，单纯性阑尾炎15例（27．78％），化脓性阑尾炎11例（20．37％），坏疽性阑尾炎20例（37．04％），阑尾周围脓肿8例（14．81％）。结论：老年人急性阑尾炎临床表现不典型，病情发展快，坏疽穿孔多，合并基础疾病较多，诊疗风险大。诊治老年人急性阑尾炎应全面评估患者的一般情况，详细询问病史以及细致的体检。早期手术是治疗老年急性阑尾炎成功的关键。积极治疗基础疾病对于降低手术风险和术后恢复都至关重要。

Analysis on diagnosis and treatment of acute appendicitis in elderly people

Objective：To summarize the characteristics of the clinical manifestation and the treatment method of a-cute appendicitis in elderly people, and to improve the level of diagnosis and treatment. Methods：The clinical data of 67 elderly patients with acute appendicitis which were admitted in the first hospital of Wuhan from January 2011 to Janu-ary 2013 were analyzed retrospectively. Results：Fifty-four patients（80.60 %） were treated with surgical treatment, 13 patients （19.40 % ） were treated with conservative treatment, all patients were cured. There were 15 （27.78 %） simple appendicitis, 11 （20.37 % ） suppurativ appendicitis, 20 （ 37.04 % ） gangrenousnecrotic appendicitis and 8 （ 14.81% ） peri- appendicular abscess in operative patients＇pathological diagnosis. Conclusion：Clinical manifestation of acute appendicitis in elderly people is not typical,and the patientrs condition changes quickly. Gangrene and perforation are frequent. Basic complication of elderly patients are also more than other people, which adds the risk of diagnosis and treatment. It should make full evaluation,ask for detailed medical history and make physical examination carfully in elderly people with appendicitis. Early operation is the key of the success of treatment of elderly people with appendicitis. Active treat- ment against basic complication is very important to the reduction of the risk of operation and to the recovery after op- eration.