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腹腔镜检查——疑似阑尾炎病例的诊断辅助手段。其在育龄女性中的应用。

Laparoscopy--a diagnostic aid in cases of suspected appendicitis. Its use in women of reproductive age.

作者信息

Spirtos N M, Eisenkop S M, Spirtos T W, Poliakin R I, Hibbard L T

出版信息

Am J Obstet Gynecol. 1987 Jan;156(1):90-4. doi: 10.1016/0002-9378(87)90212-2.

Abstract

In women of reproductive age the usefulness of laparoscopy in diagnosing acute appendicitis was evaluated. Eighty-six women underwent diagnostic laparoscopy. There was complete visualization of the appendix in 93% of the patients. Twenty-two patients were spared laparotomy. In the nonpregnant patients, salpingitis was the disease most often confused with appendicitis. Eighty-five percent of the patients with salpingitis had the onset of symptoms within 14 days of the last menstrual period, whereas acute appendicitis was found in 86% of the patients with the onset of symptoms greater than 14 days after the last menstrual period. The onset of symptoms relative to the first day of the last menstrual period differed in these two groups of patients (p less than 0.01). Patients who were spared unnecessary laparotomy had significantly diminished hospital stays (p less than 0.001). Laparoscopy was found to be a safe and effective way to diagnose acute appendicitis in women of reproductive age, and its liberal use is recommended.

摘要

对育龄期女性腹腔镜检查在诊断急性阑尾炎中的作用进行了评估。86名女性接受了诊断性腹腔镜检查。93%的患者阑尾得到了完整观察。22名患者避免了剖腹手术。在非妊娠患者中,输卵管炎是最常与阑尾炎混淆的疾病。85%的输卵管炎患者症状发作于末次月经后14天内,而86%的阑尾炎患者症状发作于末次月经后14天以上。这两组患者相对于末次月经第一天的症状发作情况存在差异(p<0.01)。避免了不必要剖腹手术的患者住院时间显著缩短(p<0.001)。腹腔镜检查被发现是诊断育龄期女性急性阑尾炎的一种安全有效的方法,建议广泛应用。

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