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頁籤選單縮合
題名 | 年輕成年女性之急性闌尾炎 |
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作者 | 吳介智; 吳誠中; 劉自嘉; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 21:5 1988.09[民77.09] |
頁次 | 頁598-603 |
分類號 | 416.243 |
關鍵詞 | 年輕成年女性; 急性闌尾炎; |
語文 | 中文(Chinese) |
中文摘要 | 本院自1982年9月到1987年3月,共有636位接受緊急闌尾切除手術,屬陰性闌尾切除者(negative appendectomy)有89位(14%)而年齡在15到45歲間的女性有136位,其中108位屬急性闌尾炎,其餘28位則是闌尾正常,因此陰性闌尾切除率為21%。28位闌尾正常者中,有22例無明顯腹內器官病變、2例為骨盆腔發炎、餘者4例分別為急性腸繫膜淋巴腺炎、早期懷孕、右輸卵管扭轉和盲腸憩室炎合併膿瘍。急性闌尾炎病例最常見的術後併發症為傷口發炎(10例),有1例死於敗血症。若有腹痛時間少於24小時,腹痛位置轉移至右下腹並有嘔吐之情形,則確診為急性闌尾炎之可能性遞增,而血中白血球數大於11000/cmm,和嗜中性白血球比例超過75%,對急性闌尾炎之診斷亦大有幫助。最後,對疑為急性闌尾炎之年輕女性,例行地請婦產科醫師檢查和對診斷不確定者留院觀察,可減少許多不必要之闌尾切除手術。 |
英文摘要 | Six hundred and thirty-six patients underwent appendectomies wity clinical diagnosis of acute appendicitis at Veterans General Hospital- Taichung from september 1982 to March 1987. Eighty -nine received negative appendectomies (14%).There were 136 females between the ages of 15 and 45, of whom 28 had negative appendectomies (21%). In patienes with normal appendixes, 22 had no intraabdominal pathologic finding, 2 had pelvic inflammatory diseases. Acute mesenteric adenitis, early pregnancy, torsion of the right Fallopian tube and cecal diverticulitis with abscess formation were found in four cases, respectively. It was found that a diagnosis of acute appendicitis was almost certain, if abdominal pain had been present for less than 24 hours, and was associated with migration of abdominal pain and vomiting. Elevated total white blook count (> 11000/mm) and neutrophil percentage (> 75%) also supported this diagnosis. Simultaneous examination of the patient by the surgeon and gynecologist, plus in-hospital observation of the patient, may reduce the incidence of negative appendectomies. |
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