Buchholz J, Mayer M, Krawzak H W, Kruse F
Chirurgische Universitätsklinik, Ruhr-Universität Bochum, Marien-hospital Herne I, Bundesrepublik Deutschland.
Zentralbl Chir. 1991;116(4):253-60.
From 1984 to 1989 78 patients over the age of 60 years were operated on acute appendicitis. Compared to appendicitis in younger people these older patients showed 3 times longer an interval between the first appearance of symptoms and their contact to the doctor, or surgical treatment. As result of this longer period appeared the high perforation rate 53.8%. In this group of patients with perforation the complication rate was 4 times higher than the intraoperative and histologically confirmed acute appendicitis. From these facts results a mortality rate of 4%. In the retrospective evaluation was also seen that there was no conclusion between the laboratory parameters, the physical symptoms and the degree of the inflammation of the evidence of perforation with local or diffused peritonitis. The inclusion of appendicitis in the differential diagnosis of acute abdominal pain in older people offers the chance of an earlier surgical treatment, so reducing the risk of postoperative complication and mortality.
1984年至1989年期间,78名60岁以上的患者接受了急性阑尾炎手术。与年轻患者的阑尾炎相比,这些老年患者从首次出现症状到就医或接受手术治疗的间隔时间长3倍。由于这段时间较长,穿孔率高达53.8%。在这组穿孔患者中,并发症发生率比术中及组织学确诊的急性阑尾炎高4倍。基于这些事实,死亡率为4%。回顾性评估还发现,实验室参数、身体症状与伴有局部或弥漫性腹膜炎的穿孔证据的炎症程度之间没有关联。将阑尾炎纳入老年人急性腹痛的鉴别诊断中,为早期手术治疗提供了机会,从而降低术后并发症和死亡率的风险。