Lüdtke F E, Müller B, Peiper H J
Allgemeinchirurgischen Universitätsklinik, Göttingen.
Zentralbl Chir. 1987;112(24):1545-51.
This retrospective study was conducted into 1.506 patients who had been admitted to the author's hospital for suspicion of acute appendicitis, between 1971 and 1979. Indications for appendectomy were handled with generosity, and primary laparotomy was applied to 44.2 per cent of all cases. Perforated appendicitis was of low incidence, accounting for only three per cent, while no acute inflammatory lesions were recordable at all from 36 per cent of removed appendices. Follow-up checks were made on all patients who had not been operated on, in the first place, not later than five years from first diagnosis. Only 15 per cent of these patients had to be eventually appendectomised. For them distribution of histological diagnoses was similar to that of patients with surgery as primary approach. Recurrence of pain was reported by one third of patients without surgery. However, only 14.9 per cent of them saw a doctor on their problem, and only 3.7 per cent had to be rehospitalised. Primary wait-and-see attitude caused no further increase in the incidence of perforated appendicitis.
这项回顾性研究针对1971年至1979年间因疑似急性阑尾炎入住作者所在医院的1506例患者展开。阑尾切除术的指征掌握较为宽松，44.2%的病例采用了一期剖腹手术。穿孔性阑尾炎发病率较低，仅占3%，而36%切除的阑尾根本未记录到急性炎症病变。对所有未接受手术的患者进行了随访检查，首先，首次诊断后不迟于5年进行随访。这些患者中最终只有15%不得不接受阑尾切除术。对他们而言，组织学诊断分布与以手术作为主要治疗方法的患者相似。三分之一未接受手术的患者报告有疼痛复发情况。然而，其中只有14.9%的患者就该问题就医，只有3.7%的患者不得不再次住院。采取初步观察等待的态度并未导致穿孔性阑尾炎发病率进一步上升。
