16例肾移植术后急性阑尾炎治疗效果研究

Acute appendicitis in kidney transplantation patients: a report 16 cases

关键词:  肾移植  阑尾炎  诊断

Key words:  acute appendicitis  kidney transplantation  diagnosis

摘要:

目的观察16例肾移植术后急性阑尾炎的治疗效果。方法对2010年至2016年解放军第309医院收治的16例肾移植术后急性阑尾炎患者的临床资料进行回顾性分析，对患者行血常规、肝肾功能、淀粉酶等检测，术前行腹部超声或CT检查，13例行手术治疗，3例保守，观察患者疗效及预后。结果16例患者中13例手术，手术效果良好，术后患者均痊愈出院，3例保守治疗，随访6月，所有患者血常规、肝肾功能基本正常。结论肾移植术后阑尾炎的诊断相对较困难，术前的腹部CT评估对于诊断肾移植术后阑尾炎和判断阑尾的位置具有重要的意义，肾移植术后阑尾炎的治疗应以手术为主，手术切口最好选择右侧腹直肌的探查切口。

Abstract:

Objective To discuss the diagnosis and therapeutic experience of acute appendicitis in kidney transplantation patients. Methods Retrospective study was performed on 16 cases treated in our department between 2010 and 2016. Upon admission, blood routine, amylase, liver and kidney function were tested. Before surgery, abdominal ultrasonography or CT was performed. Among the 16 cases, 13 patients underwent surgery and the remaining 3 patients received conservative treatment. In the end, treatment affects and long-term outcome were investigated. Results 13 of 16 patients were underwent operation. The operations were successful and all of 13 patients were discharged in average 10 days after the operation. In the following 6 months, blood routine, liver and kidney function were monitored and all the results were normally.Conclusion Acute appendicitis in kidney transplantation patients is difficult to be diagnosed. Abdominal CT plays an important role in the diagnosis of acute appendicitis and determines the location of the appendix. Surgery may be a better choice for these patients and the right rectus abdominis muscle incision should be chosen before surgery.