【摘要 】 目的 探讨结核性阑尾炎的诊断和治疗方法。方法 对1968～1997年收治的4652例阑尾炎中，经病理确诊的12例(占0.26%)结核性阑尾炎作回顾性分析。结果 本组病例的平均发病年龄为35岁，女性多见，男女比为1∶2，多为继发(7例)。12例中增殖型7例，溃疡型3例，混合型2例。术前均误诊，术中确诊2例。12例均手术治疗，单纯阑尾切除7例，盲肠部分切除2例，右半结肠切除1例，合并回盲部淋巴结切除2例，术后抗结核治疗9例。12例均顺利痊愈，无并发症。结论 结核性阑尾炎发病率低，临床表现无特异性，术前确诊困难，要注意术中观察并重视病理检查。应早期手术和术后抗结核治疗，防止并发症产生。

Diagnosis and treatment oftuberculous appendicitis TangTingyong ^* , Luo Bocheng. The People ′s Hospital of Sanshui City, Guangdong 528100 528100

【Abstract 】 Objective To studythe diagnosis and treatment of tuberculous appendicitis. Method 12 cases (0.26%) with tuberculous appendicitis diagnosed byhistopathological examination selected from 4 652 patients during 1968 to 1997 wereanalysed retrospectively. Result Themean age of the patients with tuberculous appendicitis was 35 years, the disease occurred2 times more frequently in women than in men and was usually secondary to tuberculosiselsewhere in the body (7 cases). There were 7 cases with proliferative lesions, 3 caseswith ulcerative lesions and 2 cases with two kinds of lesions. 12 cases were allmisdiagnosed preoperatively, 2 cases were diagnosed definitely in the operation. In 12cases, 7 cases underwent simple appendectomy, 2 cases partial celectomy and 1 case right hemicolectomy, appendectomy and resection of regional lymph nodes were performed on 2cases, treatment of anti-TB was given postoperatively to 9 patients. All the patientsrecovered without complications. Conclusion It ′s hard to get definite diagnosis of tuberculous appendicitis before operation because of low incidence and non-specific clinical manifestations, so careful observation in the operation and routine histopathological examination must be emphasized. Early operation and postoperative treatment of anti-TB should be advocated in order to prevent from complications.

     【Key words 】 Appendicitis, tuberculous Diagnosis Treatment

阑尾炎是外科常见病 ......