Objective To explore the clinical diagnostic and therapeutic characteristics of acute appendicitis combined with intestinal obstruction. Methods Clinical data of 114 patients with acute appendicitis combined with intestinal obstruction in our hospital during January 2001 and December 2011 were retrospectively analyzed. Results All patients with different degrees of obstruction manifestations, such as vomiting, abdominal distension, abdominal pain and stop of venting and defecation, but there was no definite history of metastatic right lower quadrant pain and the history of abdominal trauma or surgery. With appropriate gastrointestinal decompression, perioperative anti-infection, rectification of water-electrolyte disturbance and acid-base imbalance, all patients underwent exploratory laparotomy, by which aeute appendicitis was confirmed to be the cause of intestinal obstruction. According to the patients'conditions, 84 patients underwent appendectomy and enterolysis, 12 patients periappendiceal abscess drainage , 9 patients appendectomy and partial excision of small intestine, 6 patients appendectomy and resection of ileocecum and 3 patients appendectomy and reduction of intussusception of intestine respectively. At the same time, 97 patients also underwent intraop-erative small intestine decompression, celiac or pelvic flush and draining. The cure rate was 95.6% (109/114) with an average hospital stay of 12. 5 days. Conclusion Etiological diagnosis, timely operation and surgical procedure are the keys of successful treatment of acute appendicitis combined with intestinal obstruction.%目的 探讨急性阑尾炎并发肠梗阻的临床诊治特点.方法 对我院2000年1月-2011年12月收治的急性阑尾炎并发肠梗阻114例的临床资料进行回顾分析.结果 本组均有不同程度呕吐、腹胀、腹痛及停止排气、排便等肠梗阻表现,皆无确切转移性右下腹痛史,亦无腹部外伤或手术史.入院后均酌情予胃肠减压、抗感染,纠正水、电解质紊乱和酸碱平衡失调,并按肠梗阻行剖腹探查术,术中明确肠梗阻系急性阑尾炎所致.114例根据具体病情实施阑尾切除加肠粘连松解术84例,阑尾周围脓肿引流术12例,阑尾切除加坏死小肠部分切除术9例,阑尾切除加回盲部切除术6例,阑尾切除加肠套叠复位术3例.97例术中酌情行肠减压、盆腹腔冲洗并放置引流.本组治愈率95.6％(109/114),平均住院12.5 d.结论 病因诊断、围术期处理及尽早手术是急性阑尾炎并发肠梗阻救治的关键.
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