成人急性阑尾炎

最后审阅: 28 四月 2022
最后更新: 18 十一月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 腹痛
  • 厌食
  • 恶心和呕吐
  • 右下腹压痛
  • 风险评级为“中”或“高
  • 腹肌紧张、强直
  • 低血压、心动过速
  • 可触及肿块
完整详情

其他诊断因素

  • 低热
  • 面色潮红、口腔异味
  • 肠鸣音减少
  • 稀便
  • 便秘
  • 右侧髋关节屈曲(腰大肌征阳性)
完整详情

危险因素

  • 低膳食纤维
  • 个人卫生的改善
  • 吸烟
完整详情

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • C 反应蛋白 (CRP)
  • 腹部超声
  • 腹部增强 CT 扫描
完整详情

需考虑的检查

  • 尿液分析
  • 妊娠试验
  • 血型鉴定和不规则抗体筛查(Group and save)
  • 腹部 MRI
完整详情

治疗流程

急症处理

单纯性阑尾炎:适合手术

单纯性阑尾炎:不适合/不愿意接受手术

复杂性阑尾炎

撰稿人

专家顾问

John Abercrombie,

General and Colorectal Surgeon

Queen’s Medical Centre

Nottingham

UK

简介

JA is Clinical Lead for General Surgery, Getting It Right First Time.

利益声明

JA is trustee and council member of the Royal College of Surgeons of England.

鸣谢

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work is retained in parts of the content:

Dileep N. Lobo, MS, DM, FRCS, FACS

Professor of Gastrointestinal Surgery

National Institute for Health Research, Nottingham Digestive Diseases Biomedical Research Unit

Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre

Nottingham

UK

DNL declares that he has no competing interests. DNL is an author of an article cited in the topic.

同行评议者

Sarah Richards,

General Surgeon

Royal United Hospitals

Bath NHS Foundation Trust

UK

简介

SR is a specialty advisor in emergency general surgery to the Royal College of Surgeons and an honorary senior clinical lecturer and examiner for the University of Bristol medical school.

利益声明

SR declares that she has no competing interests.

编辑

Tessa Davis,

Section Editor, BMJ Best Practice

Consultant in Paediatric Emergency Medicine

Royal London Hospital

London

UK

利益声明

TD declares that she has no competing interests.

Annabel Sidwell,

Section Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Jo Haynes,

Head of Editorial, BMJ Knowledge Centre

利益声明

JH declares that she has no competing interests.

Susan Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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