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目的探讨老年人急性阑尾炎临床特点、诊断要点和早期合理的治疗方法。方法对58例手术治疗的老年人急性阑尾炎临床表现、诊断方法、手术时机及效果进行回顾性分析。结果入院后24 h内诊断手术50例,超过24 h 8例。术前明确诊断46例,其中B超提示诊断6例,CT提示诊断5例;诊断不明剖腹探查手术12例。单纯阑尾切除38例,阑尾切除及腹腔置管引流14例,单纯切开引流6例。治愈56例(96.55%),死亡2例。结论老年人急性阑尾炎临床表现多不典型,其诊断复杂而困难,尽早明确诊断、并根据不同患者特点选择个体化手术方案、在最佳时机进行手术治疗,同时积极治疗伴发病,能显著改善此类患者疗效。
Objective To investigate the clinical features, diagnosis points and early and reasonable treatment of acute appendicitis in the elderly. Methods A retrospective analysis was performed on the clinical manifestations, diagnosis, timing and effect of acute appendicitis in 58 elderly patients undergoing surgical treatment. Results Within 24 hours after admission, 50 cases were diagnosed and 8 cases were over 24 hours. Preoperative clear diagnosis of 46 cases, including B ultrasound prompted the diagnosis of 6 cases, CT prompted the diagnosis of 5 cases; laparotomy diagnosis unknown 12 cases. Simple appendectomy in 38 cases, appendectomy and abdominal drainage in 14 cases, simple incision and drainage in 6 cases. 56 cases were cured (96.55%), 2 died. Conclusions The clinical manifestations of acute appendicitis in the elderly are mostly atypical. The diagnosis is complicated and difficult. The diagnosis of acute appendicitis is made as soon as possible. Individualized surgical plans can be selected according to the characteristics of different patients. Surgery can be performed at the best time. At the same time, active appendicitis can be significantly improved Class patient efficacy.