治疗-Appendicitis

If you have appendicitis, your appendix will usually need to be removed as soon as possible. This operation is known as an appendicectomy or appendectomy.

Surgery is often also recommended if there's a chance you have appendicitis but it's not been possible to make a clear diagnosis.

这是因为去除附录比爆炸的风险被认为更安全。

In humans, the appendix does not perform any important function and removing it does not cause any long-term problems.

Appendicectomy (appendectomy)

Removal of the appendix is carried out undergeneral anaesthetic使用钥匙孔或开放手术。

钥匙孔手术

钥匙孔手术(laparoscopy) is usually the preferred method of removing the appendix because the recovery tends to be quicker than with open surgery.

The operation involves making 3 or 4 small cuts (incisions) in your tummy (abdomen).

Special instruments are inserted, including:

• a tube that gas is pumped through to inflate your abdomen – this allows the surgeon to see your appendix more clearly and gives them more room to work
• a laparoscope – a small tube with a light and a camera, which relays images of the inside of the abdomen to a television monitor
• small surgical tools used to remove the appendix

After your appendix has been removed,可溶解的针迹may be used to close the incisions.

If regular stitches are used, they'll need to be removed at your GP surgery 7 to 10 days later.

Open surgery

在某些情况下，不建议进行钥匙孔手术，而是使用开放手术。

These include:

• when the appendix has already burst and formed a lump called an appendix mass
• people who have previously had open abdominal surgery

在开放手术中，在腹部右下方进行一次较大的切割，以去除附录。

When there's widespread infection of the inner lining of the abdomen (peritonitis), it's sometimes necessary to operate through a cut along the middle of the abdomen. This procedure is called a laparotomy.

与钥匙孔手术一样，使用可溶解的针迹或常规针迹闭合切口，这些针迹稍后需要在以后切除。

After both types of surgery, the removed appendix is sent to a laboratory to check for signs of cancer.

This is a precautionary measure and it's rare for a serious problem to be found.

Recovery

One of the main advantages of keyhole surgery is the recovery time tends to be short and most people can leave hospital a few days after the operation.

If the procedure is carried out promptly, you may be able to go home within 24 hours.

开放或复杂的手术（例如，如果您患有腹膜炎），可能需要一周的时间才能回家。

For the first few days after the operation it's likely you'll have some pain and bruising. This improves over time, but you can take painkillers if necessary.

If you have had keyhole surgery, you may have pain in the tip of your shoulder for about a week.

This is caused by the gas that was pumped into your abdomen during the operation.

You may also haveconstipationfor a short period after the operation.

To help reduce this, do not take codeine painkillers, eat plenty offibre, and drink plenty of fluids.

Your GP can prescribe medication if the problem is particularly troublesome.

Before leaving hospital, you'll be advised about caring for your wound and what activities you should avoid.

You should be able to return to normal activities in a couple of weeks, although you may need to avoid more strenuous activities for 4 to 6 weeks after open surgery.

Your surgeon should discuss this with you.

When to get medical advice

While you recover, it's important to keep an eye out for signs of any problems.

Contact your care team at the hospital or your GP if you:

• 增加疼痛和肿胀
• start vomiting repeatedly
• have a high temperature
• 从伤口中排出
• notice the wound is hot to touch

These symptoms could be a sign of infection.

风险

Removal of the appendix is one of the most commonly performed operations in the UK, and serious or long-term complications are rare.

But like all types of surgery, there are some risks, including:

• wound infection – althoughantibioticsmay be given before, during or after the operation to minimise the risk of serious infections
• bleeding under the skin that causes a firm swelling (haematoma) – this usually gets better on its own, but you should see your GP if you're concerned
• 疤痕 - 两种类型的手术都会在切口的地方留下一些疤痕
• a collection of pus (abscess） - 在极少数情况下，附录爆发引起的感染会导致手术后脓肿
• 疝气 - 在开放切口或钥匙孔手术中使用的任何切口

The use of general anaesthetic also carries some risks, such as the risk of an allergic reaction or inhaling stomach contents, leading to肺炎.

But serious complications like this are very rare.

Alternatives to emergency surgery

In some cases, appendicitis can cause a lump called an appendix mass to form on the appendix.

肿块是由附录和脂肪组织制成的，是身体试图解决问题并自我修复的方式。

If an appendix mass is found during an examination, your doctor may decide it's not necessary to operate immediately.

相反，您将获得一门课程antibioticsand an appointment to have an operation a few weeks later, when the mass has settled.

There's not enough clear evidence to suggest that antibiotics could be used to treat appendicitis as an alternative to surgery.