内镜逆行阑尾炎治疗术对不典型急性阑尾炎的诊断与治疗价值

Diagnostic and therapeutic value of endoscopic retrograde appendicitis therapy for atypical acute appendicitis

摘要:

目的 探讨内镜逆行阑尾炎治疗术（ERAT）对不典型急性阑尾炎的诊断与治疗价值。方法 2015年1月至2016年12月于江苏省人民医院就诊的所有疑诊为不典型急性阑尾炎的48例患者，按照治疗方法不同分为ERAT组和保守治疗组，比较两组患者最终阑尾切除率。结果 因病情复杂或个人意愿等原因，ERAT组的24例患者中仅17例接受了内镜下治疗，其中16例被诊断为急性阑尾炎，经ERAT治疗后5例因疾病复发行外科阑尾切除,切除率31.3%（5/16）；保守治疗组的24例患者均接受抗生素治疗，20例因再发阑尾炎行外科阑尾切除，其中1例出现阑尾穿孔,切除率83.3%（20/24）。ERAT组的外科切除率较保守治疗组低（?2=11.111，P<0.05）。结论 ERAT对不典型急性阑尾炎具有较高的诊断与治疗价值。

Abstract:

Objective To investigate the value of endoscopic retrograde appendicitis therapy (ERAT) in the diagnosis and treatment of atypical acute appendicitis. Methods All the 48 patients suspected of atypical acute appendicitis in Jiangsu Province Hospital from January 2015 to December 2016 were randomly divided into ERAT group and conservative treatment group according to the treatment method. The final appendectomy rate of the two groups was analyzed. Results Only 17 of the 24 patients in the ERAT group received endoscopic treatment because of complex conditions or personal wishes, and 16 cases were diagnosed as acute appendicitis. Surgical resection was performed in 5 cases because of recurrence of the disease after ERAT, and the appendectomy rate was 31.3% (5/16). In the conservative treatment group, all 24 patients were treated with antibiotics. Twenty of them underwent surgical resection with appendectomy rate of 83.3% (20/24), and 1 of them had appendiceal perforation. The appendectomy rate of the ERAT group was significantly lower than that of the conservative treatment group ( =11.111, P<0.05). Conclusion ERAT has a high diagnostic and therapeutic value for atypical acute appendicitis.