老年肥胖急性阑尾炎患者手术治疗的研究进展

Research Progress on Surgical Treatment of Elderly Obese Patients with Acute Appendicitis

摘要: 急性阑尾炎(Acute appendicitis, AA)是临床常见急性化脓性感染疾病，是诱发急性腹痛并需外科治疗的常见病之一，属于普外科常见的急腹症，发病率在所有急腹症中排前位，西方国家高达10%，我国发病率为4%~8.5%。急性阑尾炎具有发病急、病情进展快、症状重等特点，持续伴阵发性加剧的右下腹疼痛为典型症状，在阑尾点按压能感受到强烈的痛感，伴有呕吐、恶心及低热等临床病症。若治疗不及时，则极易发生阑尾脓肿、穿孔，引起败血症、多器官功能障碍等严重并发症，从而对患者的生命健康造成严重威胁。临床上，急性阑尾炎手术普遍采用腹腔镜手术(LA)和开放手术(OA)疗法，本研究拟比较老年肥胖急性阑尾炎患者行开放阑尾切除术与腹腔镜下阑尾切除术的临床效果，总结如何改善其病情和预后，并能进一步提升其生存质量。

Abstract: Acute appendicitis is a common acute suppurative infectious disease in clinical practice. It is one of the common diseases that induce acute abdominal pain and require surgical treatment. It is a common acute abdomen in general surgery. Its incidence rate ranks first among all acute ab-dominal diseases, and it is as high as 10% in Western countries. The incidence rate in China is 4% to 8.5%. Acute appendicitis has the characteristics of acute onset, rapid disease progression, and severe symptoms. Sustained and exacerbating paroxysmal right lower quadrant pain is a typical symptom. Strong pain can be felt when pressing the appendix point, accompanied by vomiting, nausea, low-grade fever and other clinical symptoms. If not treated in time, appendiceal abscess and perforation can easily occur, causing sepsis, multiple organ dysfunction and other serious com-plications, thus posing a serious threat to the patient’s life and health. Clinically, laparoscopic sur-gery and open surgery are commonly used for acute appendicitis surgery. This study aims to com-pare the clinical effects of open appendectomy and laparoscopic appendectomy in elderly obese pa-tients with acute appendicitis, summarize how to improve their condition and prognosis, and can further improve patient safety.