急性未穿孔闌尾炎248例保守治療和手術治療的療效分析

[摘要] 目的 對急性未穿孔闌尾炎的手術治療和保守治療的療效進行對比分析。 方法 選取248例急性未穿孔闌尾炎患者，144例行手術治療，104例行保守治療，記錄兩組患者在治療后及治療過程中的變化情況。 結果 手術組術后出現傷口感染者10例，出院后隨訪12個月，6例出現腸梗阻；保守組治療2～4 d后病情好轉，但有4例行保守治療后癥狀改善不明顯，接受了手術治療，隨訪12個月，10例患者復發。 結論 保守方式治療急性未穿孔闌尾炎能在短時間內出現滿意療效，減少患者痛苦，明顯縮短住院期限，但梗阻性闌尾炎復發率較高。

[關鍵詞] 急性闌尾炎；手術治療；保守治療

[中圖分類號] R656.8 [文獻標識碼] B [文章編號] 2095-0616（2012）22-203-02

Efficacy analysis of 124 cases with acute non-perforated appendicitis by conservative treatment and surgical treatment

ZHANG Yingyu LIN Jinsong

Thirteenth Ward，the Hospital of Nan'an City，Nan'an 362300，China

[Abstract] Objective To compare the efficacy of surgical treatment and conservative treatment in acute non-perforated appendicitis. Methods 248 cases with acute non-perforated appendicitis were selected，144 cases were treated by surgical treatment，104 cases were treated by conservative treatments，recorded the changes of the two groups after the treatment and during the treatment. Results 10 cases occurred wound infection in surgery group，12 months， follow-up after left hospital，6 cases occurred intestinal obstruction； After 2 to 4 days， conservative treatment，their conditions had been improved，but 4 cases had no obvious improvement after conservative treatment，accepted the surgical treatment and follow-up a year，10 patients relapsed. Conclusion Conservative treatment in acute non-perforated appendicitis can occur satisfactory outcome in a short period. It can reduce the suffering of patients and significantly shorter hospital stay period，but the recurrence rate of obstructive appendicitis is high.

[Key words] Acute appendicitis；Surgery treatment；Conservative treatment

近些年，一些學者主張急性闌尾炎一旦確診就須手術治療，這樣可以有效減少其他并發癥的出現幾率[1]。可是，由于其他外界因素的影響或應部分患者的強烈要求，該病治療方式須先行保守治療，即使診斷明確。為研究急性未穿孔闌尾炎的有效治療方法，選取筆者所在醫院248例診斷明確、腹痛癥狀持續不超過2 d的急性未穿孔闌尾炎患者資料進行分析對比，并對其隨訪12個月，筆者發現保守治療方式治療急性未穿孔闌尾炎療效較好，現報道如下。

1 資料與方法

1.1 一般資料

選取筆者所在醫院2008年2月～2012年2 月收治的248例診斷明確的急性未穿孔闌尾炎患者資料進行分析，為保持研究結果的準確性，入選患者需滿足以下條件：入選患者年齡14～61歲；入選患者的持續腹痛癥狀在2 d之內，且已發生腹膜炎；……