Gonçalves M, Martins A P, Leal M J
Serviço de Cirurgia Pediátrica, Hospital de Santa Maria, Lisboa.
Acta Med Port. 1993 Aug-Sep;6(8-9):377-82.
From January 1st, 1987 to December 31st, 1989, 267 patients were operated upon for acute appendicitis representing 97% of emergency laparotomies at the Pediatric Surgery Department of Santa Maria Hospital (HSM); of these, 207 records were analysed using a retrospective protocol and the results were as follows: most frequent symptoms were abdominal pain (99% of cases) and anorexia (86%). Referral for surgical evaluation was made in 35.8% of cases 48 hours after the onset of symptoms; surgery was performed in 129 patients (62.4%) in advanced stages of disease, with histopathological examinations of necrotic, perforated and gangrenous appendices. 15 patients (7.2%) had no appendicitis-11 were found to have follicular hyperplasia and 4 normal histology; of these, luminal distention by parasitic eggs was found in 4. Antibiotic therapy was used in 89 patients preoperatively and in 200 patients postoperatively; cefoxitin was the most commonly used in 89.9% and 83.0% respectively. There were 19 complications (9.2%): 8 parietal, 5 pelvic and 1 subphrenic abscesses, 4 total or partial obstructions and 1 lost drain; 4 patients (1.9%) were reoperated and there was no mortality.
1987年1月1日至1989年12月31日，267例患者接受了急性阑尾炎手术，占圣玛丽亚医院（HSM）小儿外科急诊剖腹手术的97%；其中，采用回顾性方案分析了207份记录，结果如下：最常见的症状是腹痛（99%的病例）和厌食（86%）。35.8%的病例在症状出现后48小时进行了手术评估；129例患者（62.4%）在疾病晚期接受了手术，并对坏死、穿孔和坏疽性阑尾进行了组织病理学检查。15例患者（7.2%）没有患阑尾炎——11例发现有滤泡增生，4例组织学正常；其中，4例发现有寄生虫卵导致的管腔扩张。89例患者术前使用了抗生素，200例患者术后使用了抗生素；头孢西丁分别在89.9%和83.0%的病例中最常使用。有19例并发症（9.2%）：8例腹壁脓肿、5例盆腔脓肿和1例膈下脓肿、4例完全或部分肠梗阻和1例引流管丢失；4例患者（1.9%）接受了再次手术，无死亡病例。
