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目的探讨老年人急性阑尾炎的临床特点、诊断和治疗方法,尽量做到早诊断、早治疗。方法选取2009年6月至2010年7月来我院就诊的老年人急性阑尾炎患者65例,对其临床资料进行回顾性分析。结果手术治疗58例,占82·9%;保守治疗7例,占12·1%;58例手术治疗后,均痊愈,无死亡案例;术后并发症中,切口感染7例,占12·1%,肺部感染16例,占27·6%,尿路感染6例,占10·3%,腹胀3例,占5·2%,心功能不全5例,占8·6%;29例伤口是一期愈合,切口感染的患者经引流后二期愈合,尿路感染、肺部感染经抗感染治疗最长6d痊愈。结论老年人急性阑尾炎临床表现多样化,症状与病理改变不相符,病情发展迅速,阑尾容易穿孔,并发症多,术后恢复慢,应早诊断、早手术,以提高治愈率。
Objective To investigate the clinical features, diagnosis and treatment of acute appendicitis in the elderly and try its best to make early diagnosis and early treatment. Methods A total of 65 elderly patients with acute appendicitis who came to our hospital from June 2009 to July 2010 were retrospectively analyzed. Results Surgical treatment of 58 cases, accounting for 82.9%; Conservative treatment in 7 cases, accounting for 12.1%; 58 cases of surgery, were cured, no deaths; postoperative complications, incision infection in 7 cases, accounting for 12 1%, pulmonary infection in 16 cases, accounting for 27.6%, urinary tract infection in 6 cases, accounting for 10.3%, abdominal distension in 3 cases, accounting for 5.2%, cardiac insufficiency in 5 cases, accounting for 8.6%; 29 Cases of wounds is a healing, incision infection in patients with secondary drainage after drainage, urinary tract infection, lung infection by anti-infection therapy up to 6d cured. Conclusions The clinical manifestations of acute appendicitis in the elderly are diversified. The symptoms and pathological changes are not consistent. The disease develops rapidly. The appendix is easy to perforate. The complications are numerous and the postoperative recovery is slow. Early diagnosis and early operation should be done to improve the cure rate.