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[女性急性阑尾炎的误诊情况]

[Wrong diagnoses of acute appendicitis in women].

作者信息

Barczyński M, Cichoń S, Słowiaczek M, Kempf Z, Bonczar M, Włodyka J

机构信息

Katedry i Kliniki Chirurgii Ogólnej Collegium Medicum UJ w Krakowie.

出版信息

Przegl Lek. 1995;52(12):575-7.

PMID:8834653
Abstract

In the years 1988 through 1992, 434 patients with acute appendicitis were operated at Third Department of Surgery, Medical Academy, in Kraków. The group included 201 females aged 14 to 90 years of life. In 159 women the diagnosis of acute appendicitis was confirmed, whereas 42 patients were subjected to surgical procedures due to other than appendicitis conditions located within the abdominal cavity. Surgeries prompted by symptoms suggesting appendicitis were most often performed in women with gynecological diseases. Only in several cases laparotomies were performed for other reasons. Wrong diagnoses were most often noted in women below 20 years of life and in the group between 40 and 60 years of life. The introduction of routine ultrasound examinations into the diagnostic management of acute peritonitis and diseases of the reproductive system might result in decrease of the number of diagnostic errors in acute appendicitis in women. An emergency procedure performed when the diagnosis is unclear is recommended rather than prolonged observation. The latter often results in delayed diagnosis of acute appendicitis when diffuse peritonitis develops.

摘要

1988年至1992年期间,克拉科夫医学院第三外科为434例急性阑尾炎患者实施了手术。该组包括201名年龄在14岁至90岁之间的女性。其中159名女性急性阑尾炎诊断得到证实,而42名患者因腹腔内除阑尾炎以外的其他病症接受了外科手术。因提示阑尾炎的症状而进行的手术最常见于患有妇科疾病的女性。仅在少数情况下因其他原因进行了剖腹手术。错误诊断最常出现在20岁以下的女性以及40至60岁的人群中。在急性腹膜炎和生殖系统疾病的诊断管理中引入常规超声检查可能会减少女性急性阑尾炎的诊断错误数量。当诊断不明确时,建议进行急诊手术而非延长观察时间。后者往往会在弥漫性腹膜炎发生时导致急性阑尾炎的诊断延迟。

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