《阑尾切除术》.pptVIP

 ◆ Acute Simple Appendicitis. ◆ Acute Suppurative or Gangrenous appendicitis . ◆ Acute Perforating Appendicitis. ◆ Chronic Relapsing Appendicitis. ●B-US—Young woman.  ●Fluid therapy. ●Intravenous Antibiotics. ●Nasogastric suction.  ●Local or General anaesthesia.  Epidural Anaesthesia.●Lie Supine. ` ◆Activity in Early—Prevent Intestinal  Adhesion. ◆Normal Intestinal Activity—Oral Fluids. ◆Perforated Appendicitis—According to Principals of Peritonitis.◆Drain the Peritorium Cavity. ※Hemorrhage.※ Wound infection and dehiscence.※ peritoneal cavity abscess.※ Appendix-stump infection.※ Adhesive ileus.※ Intestinal fistula. * 阑尾切除术Appendectomy 主讲 刘栋才副教授 STRESSES AND DIFFICULTIES ●Local anatomy of appendix. ●Basic conception: McBurney point. ●Complications of acute appendicitis. 第一部分 阑尾的外科解剖 PartⅠ: Surgical anatomy of appendix ◆General Conciderations. ◆ Anatomic Position of Appendix. ◆McBurney point. ◆Mesoappendix. ● positions of the appendix   ● local anatomy of the appendix ●vessels of the appendix ● Essentials of Detecting Appendix: ①the Taeniae of the Colon converge at the Base of the Appendix. ②Approximately 2.5cm Below the ileocecal Valve. ACUTE APPENDICTTIS: Essentials of Diagnosis: ●Abdomial pains. ●Anorexia, nausea and vomiting. ●Localized abdominal tenderness. ●Low-grade fever. ●Leukocytosis. DIFFERENTIAL DIAGNOSIS: ●Mesenteric Lymphadentitis. ●Ureteral or Renal Calculi. ●Female Pelvic Disorders: ＆A ruptured ovarian follicle. ＆pelvic inflammatory disease. ＆Twisted ovarian cyst. ＆Ectopic pregnancy. ●Other Acute Surgical Emergencies. 第二部分 阑尾切除术 Appendectomy Indications ◆ Periappendiceal Abscess. ◆ Benign Tumor of the Appendix. ◆ Carcinid of the Appendix(2cm)。 ◆ Appendicolithiasis. ●A history of more than 3 days’ duration. ●A right iliac swelling which is almost certainly an appendix abscess. Contra-indications Preoperative Management Anaesthesia and