雷三林.阑尾切除术end.pptVIP

Appendicitis is a common and frequently-occurring general surgery ，appendectomy is the oldest and most common surgical operation. In1886 ， Regineld Fitz proposed as a treatment way to appendicitis appendectomy have been centuries Approach is not complicated ，but sometimes abnormal position in the appendix, adhesions around the case, the appendix of the search, separation and removal of all there will be some difficulties. Dissection Length ：Generally 5~7cm, Diameter 0.5~0.7cm, Diameter 0.2~0.3cm. Surface projection ：McBurney’s point—Umbilical and right iliac spine connection, the outer 1/3 Blues Point —The two anterior superior iliac spine connection, and the right 1/3 Position ：Figure 1. Most acute simple appendicitis .Non-surgical treatment ineffective 2.suppurative appendicitis or gangrenous appendicitis 3. Children, elderly or pregnant women acute appendicitis 。4．Chronic recurrent appendicitis 5．Appendix ascaris psychosis .  1.Young female pelvic ultrasound Contribute to the differential diagnosis of appendicitis2. rectification fluid and electrolyte disotders3. Preoperative prophylactic use of antibiotics  Preoperativepreparation 4. If there is intestinal obstruction should be perform gastrointestinal decompression 5 . Intramuscular injection of progesterone during pregnancy appendicitis should be to reduce the contraction of the uterus to prevent miscarriage or prema-ture delivery.  Local anesthesia or epidural anesthesia Children with general anesthesia Supine position right gluteal Slightly booster。 modus operandi :total resection subtotal ectomy technique：Subtotal ectomy in two ways direct motion—First Department of membrane separation vessel ligation , and then remove the appendix retrograde motion—First cut off the root of the appendix , and then membrane separation system of vascular ligation  2. Free appendix Wet gauze pad protection ，Filed revealed anterior cecal appendix ，If the search for appendi