尼日利亚迈杜古里大学教学医院的阑尾炎及其外科治疗经验

Appendicitis and its surgical management experience at the University of Maiduguri Teaching Hospital Nigeria.

作者信息

Ali N, Aliyu S

机构信息

Department of Surgery, College of Medical Sciences, University of Maiduguri, Nigeria.

出版信息

Niger J Med. 2012 Apr-Jun;21(2):223-6.

PMID:23311196

Abstract

BACKGROUND

Acute appendicitis and its complications is still the most common cause of acute abdominal pain that will require surgical intervention in most parts of the West African sub-region. This study is a review of our management and outcome of acute appendicitis in the University of Maiduguri Teaching Hospital [UMTH].

METHOD

A retrospective and prospective audit of all patients with acute appendicitis seen and managed over an 8- year period [2002-2009 inclusive] in the UMTH is presented. Materials used included patients demographic variables, clinical presentation, laboratory data, operative findings and treatment outcome.

RESULTS

One thousand two hundred and fifty-seven patients were studied. These were 426 (33.9%) males and 831 (66.1%) females; a male to female ratio of 1:2. The mean age was 32.4 15.0 years. All the patients were admitted with abdominal pain that was initially located at the right iliac fossa in 480 (38.2%), periumbilical in 393 (31.3%) and diffused in 351(27.9%) patients. Vomiting 85.7%, fever 73.0% and anorexia 49.0% were the most frequent symptoms. The mean duration of illness was 72 hours. Right iliac fossa pain and tenderness were present in 1112 (88.46%) patients. The total white cell count was significantly raised (p < 0.05). All the patients had appendicectomy, 295 (23.47%) of the appendices were perforated at operation and 200 (15.9%) of the removed appendices had no histological evidence of inflammation. The complication rate was 36.2% and wound infection (28.30%) was the most common. The mean hospital stay was 3 days. There were 12 deaths; a mortality rate of 0.9%; mostly patients with ruptured appendix and peritonitis.

CONCLUSION

The diagnosis of appendicitis is clinical and supported by a raised total white cell count with neutrophilia. The negative appendicectomy rate of 15.9% falls below the range reported in other studies. More than a fifth of the appendices were perforated and mortality was low.

摘要

背景

在西非次区域的大部分地区，急性阑尾炎及其并发症仍是需要手术干预的最常见急性腹痛病因。本研究回顾了迈杜古里大学教学医院（UMTH）对急性阑尾炎的治疗及结果。

方法

对UMTH在8年期间（2002年至2009年）诊治的所有急性阑尾炎患者进行回顾性和前瞻性审计。所用资料包括患者的人口统计学变量、临床表现、实验室数据、手术所见及治疗结果。

结果

共研究了1257例患者。其中男性426例（33.9%），女性831例（66.1%），男女比例为1:2。平均年龄为32.4±15.0岁。所有患者均因腹痛入院，最初位于右下腹的有480例（38.2%），位于脐周的有393例（31.3%），弥漫性腹痛的有351例（27.9%）。最常见的症状为呕吐（85.7%）、发热（73.0%）和厌食（49.0%）。平均病程为72小时。1112例（88.46%）患者有右下腹疼痛和压痛。白细胞总数显著升高（p<0.05）。所有患者均接受了阑尾切除术，术中发现295例（23.47%）阑尾穿孔，切除的阑尾中有200例（15.9%）无炎症组织学证据。并发症发生率为36.2%，伤口感染（28.30%）最为常见。平均住院时间为3天。有12例死亡，死亡率为0.9%；主要是阑尾破裂和腹膜炎患者。