妊娠阑尾炎的诊治体会_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 王辉 , 孟松 , 李超 , 时林森 , 姚立彬 ,  朱孝成

徐州医科大学附属医院胃肠外科（江苏徐州 221000）;

Corresponding author：

朱孝成, Email: zxchlzh@gmail.com

Keywords：

妊娠; 阑尾炎; 诊断; 治疗

DOI：

10.7507/1007-9424.20160357

Video：

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目的探讨妊娠阑尾炎的诊断与最佳手术时间。方法回顾性分析2011年10月至2015年10月期间我院诊治的50例妊娠阑尾炎患者的临床资料。根据发病后至手术时间分为观察组和对照组，观察组为发病时间24 h内进行手术者，对照组为发病时间超过24 h进行手术者。比较2组患者的平均住院时间、早产率、切口感染率和术中引流管放置率。结果 2组患者的年龄、孕周、血白细胞计数及体温比较差异均无统计学意义（P＞0.05），观察组急性蜂窝织性阑尾炎患者所占比例明显高于对照组（χ²=9.93，P=0.002），而对照组急性坏疽性阑尾炎患者所占比例明显高于观察组（χ²=9.93，P=0.002）。观察组的住院时间明显短于对照组（t=2.36，P=0.02），早产率、切口感染率及术中引流管放置率均明显低于对照组（χ²=5.56，P=0.018；χ²=5.35，P=0.021；χ²=8.42，P=0.004）。结论妊娠阑尾炎强调早期诊断和及早手术治疗，发病时间24 h内进行手术治疗效果较好。

Citation： 王辉, 孟松, 李超, 时林森, 姚立彬, 朱孝成. 妊娠阑尾炎的诊治体会. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(11): 1397-1399. doi: 10.7507/1007-9424.20160357 Copy

1.	Holzer T, Pellegrinelli G, Morel P, et al. Appendectomy during the third trimester of pregnancy in a 27-year old patient:case report of a "near miss" complication. Patient Saf Surg, 2011, 5(1):11.
2.	De Franca Neto AH, Do Amorim MM,Nóbrega BM. Acute appendicitis in pregnancy:literature review. Rev Assoc Med Bras, 2015, 61(2):170-177.
3.	Jung SJ, Lee do K, Kim JH, et al. Appendicitis during pregnancy:The clinical experience of a Secondary Hospital. J Korean Soc Coloproctol, 2012, 28(3):152-159.
4.	Aggenbach L, Zeeman GG, Cantineau AE, et al. Impact of appendicitis during pregnancy:no delay in accurate diagnosis and treatment. Int J Surg,2015, 15:84-89.
5.	Dasari P, Maurya DK. The consequences of missing appendicitis during pregnancy. BMJ Case Rep, 2011, 2011.http://cn.bing.com/academic/profile?id=2166020361&encoded=0&v=paper_preview&mkt=zh-cn.
6.	Carlin A, Alfirevic Z. Physiological changes of pregnancy and moni-toring. Best Pract Res Clin Obstet Gynaecol, 2008, 22(5):801-823.
7.	Wang PI, Chong ST, Kielar AZ, et al. Imaging of pregnant and lacta-ting patients:part2, evidence-based review and recommendations. AJR Am J Roentgenol, 2012, 198(4):785-792.
8.	Hiersch L, Yogev Y, Ashwal E, et al. The impact of pregnancy on the accuracy and delay in diagnosis of acute appendicitis. J Matern Fetal Neonatal Med, 2014, 27(13):1357-1360.
9.	Young BC, Hamar BD, Levine D, et al. Medical management of ruptured appendicitis in pregnancy. Obstet Gynecol, 2009, 114(2 Pt 2):453-456.
10.	Silvestri MT, Pettker CM, Brousseau EC, et al. Morbidity of appen-dectomy and cholecystectomy in pregnant and nonpregnant women. Obstet Gynecol, 2011, 118(6):1261-1270.
11.	Abbasi N,Patenaude V,Abenhaim HA. Management and outcomes of acute appendicitis in pregnancy-population-based study of over 7 000 cases. BJOG, 2014, 121(12):1509-1514.
12.	Chung JC, Cho GS, Shin EJ, et al. Clinical outcomes compared between laparoscopic and open appendectomy in pregnant women. Can J Surg, 2013, 56(5):341-346.
13.	Yilmaz HG, Akgun Y, Bac B, et al. Acute appendicitis in pregnancy-risk factors associated with principal outcomes:a case control study. Int J Surg, 2007, 5(3):192-197.
14.	Zhang Y, Zhao YY, Qiao J, et al. Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy. Chin Med J (Engl), 2009, 122(5):521-524.
15.	Brown JJ, Wilson C, Coleman S, et al. Appendicitis in pregnancy:an ongoing diagnostic dilemma. Colorectal Dis, 2009, 11(2):116-122.
16.	周慧梅, 李威, 朱兰. 妊娠期急性阑尾炎诊治进展. 中国计划生育和妇产科, 2015, 7(2):16-18.

1. Holzer T, Pellegrinelli G, Morel P, et al. Appendectomy during the third trimester of pregnancy in a 27-year old patient:case report of a "near miss" complication. Patient Saf Surg, 2011, 5(1):11.
2. De Franca Neto AH, Do Amorim MM,Nóbrega BM. Acute appendicitis in pregnancy:literature review. Rev Assoc Med Bras, 2015, 61(2):170-177.
3. Jung SJ, Lee do K, Kim JH, et al. Appendicitis during pregnancy:The clinical experience of a Secondary Hospital. J Korean Soc Coloproctol, 2012, 28(3):152-159.
4. Aggenbach L, Zeeman GG, Cantineau AE, et al. Impact of appendicitis during pregnancy:no delay in accurate diagnosis and treatment. Int J Surg,2015, 15:84-89.
5. Dasari P, Maurya DK. The consequences of missing appendicitis during pregnancy. BMJ Case Rep, 2011, 2011.http://cn.bing.com/academic/profile?id=2166020361&encoded=0&v=paper_preview&mkt=zh-cn.
6. Carlin A, Alfirevic Z. Physiological changes of pregnancy and moni-toring. Best Pract Res Clin Obstet Gynaecol, 2008, 22(5):801-823.
7. Wang PI, Chong ST, Kielar AZ, et al. Imaging of pregnant and lacta-ting patients:part2, evidence-based review and recommendations. AJR Am J Roentgenol, 2012, 198(4):785-792.
8. Hiersch L, Yogev Y, Ashwal E, et al. The impact of pregnancy on the accuracy and delay in diagnosis of acute appendicitis. J Matern Fetal Neonatal Med, 2014, 27(13):1357-1360.
9. Young BC, Hamar BD, Levine D, et al. Medical management of ruptured appendicitis in pregnancy. Obstet Gynecol, 2009, 114(2 Pt 2):453-456.
10. Silvestri MT, Pettker CM, Brousseau EC, et al. Morbidity of appen-dectomy and cholecystectomy in pregnant and nonpregnant women. Obstet Gynecol, 2011, 118(6):1261-1270.
11. Abbasi N,Patenaude V,Abenhaim HA. Management and outcomes of acute appendicitis in pregnancy-population-based study of over 7 000 cases. BJOG, 2014, 121(12):1509-1514.
12. Chung JC, Cho GS, Shin EJ, et al. Clinical outcomes compared between laparoscopic and open appendectomy in pregnant women. Can J Surg, 2013, 56(5):341-346.
13. Yilmaz HG, Akgun Y, Bac B, et al. Acute appendicitis in pregnancy-risk factors associated with principal outcomes:a case control study. Int J Surg, 2007, 5(3):192-197.
14. Zhang Y, Zhao YY, Qiao J, et al. Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy. Chin Med J (Engl), 2009, 122(5):521-524.
15. Brown JJ, Wilson C, Coleman S, et al. Appendicitis in pregnancy:an ongoing diagnostic dilemma. Colorectal Dis, 2009, 11(2):116-122.
16. 周慧梅, 李威, 朱兰. 妊娠期急性阑尾炎诊治进展. 中国计划生育和妇产科, 2015, 7(2):16-18.

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