Appendectomy
Introduction
闌尾炎是指闌尾(俗稱盲腸)因糞便嵌塞或其他原因而發炎。闌尾炎發作迅速,通常出現腹痛及不適等徵狀。幾小時後,腹痛加劇並轉移至右下腹部位,並伴有噁心、嘔吐及發燒等情況。無論男女,任何年齡均可出現闌尾炎。發炎的闌尾應以手術切除,否則它會因破裂而演變為致命的腹膜炎。
其他需要進行闌尾切除術的情況包括進行其他手術程序時偶然切除,或出現闌尾腫瘤。
Surgical procedure
- The surgery requires a general anaesthetic.
- 程序可以用開放性闌尾切除術或腹腔鏡闌尾切除術進行
開放性闌尾切除術
˙ 在右下腹或中下腹部位開一切口
腹腔鏡闌尾切除術
˙ 在腹部分別開一至三個小切口,以置入儀器
- 進入腹膜腔檢查內部情況,並確定病原
- 結紮闌尾截停其血液供應,並切除闌尾
- If necessary, drain the accumulated fluid with abdominal drainage.
- Suturing a wound
Surgical risk
麻醉涉及的併發症(非常罕見,出現機率低於 0.01%,但可導致永久損傷甚至死亡):
- Cardiovascular complications: myocardial infarction or ischaemic heart disease, stroke, deep vein thrombosis, pulmonary embolism, etc.
- Respiratory tract complications: atelectasis, pneumonia, asthma attack, chronic bronchitis
- Allergic reactions and shock
- 手術程序涉及的併發症:
- 傷口感染及裂開(5 – 30%)
- 盆腔積液或膿腫
- 糞瘻
- 附近其他器官受損,例如膀胱、結腸(~ 5%)
- 結紮位置出現滲漏(1%)
- Adhesive intestinal obstruction
- Death (0.1 – 1%)
Pre-operative preparation
- 一旦確診,通常會列為緊急手術進行
- Fasting 6 to 8 hours before surgery
- 可能需要剃掉陰毛
- Change into hospital scrubs before entering the operating room.
- 進行手術前先排清尿液
- Pre-medication and intravenous infusion may be required.
- 建議預先服用抗生素
- Inform your doctor about any drug sensitivities, regular medications, or other medical conditions you have.
Post-operative care
一般來說,在進行手術後:
- 可能需要繼續進行靜脈內滴注直至能夠進食為止
- 可能需要再服用更多或者整個療程的抗生素
- 可能因為插管而導致喉部輕微不適或疼痛
- 可能感到噁心或作嘔,如果情況嚴重請通知護士
- 如果增發止痛藥後仍不足以止痛,請通知護士
- 手術 6 個小時後即可起床活動
- 一般手術後 2 天即可回家
Wound cuisine
- 除另有指示外,手術後頭一、兩天應保持敷料完好和乾爽
- 從第 2 天起,檢查傷口後或許可以換上較少的敷料
- 避免穿著緊身衣物或對傷口/敷料施加壓力
- 約一星期可以除去縫線或皮夾(如有)
Food and drink
- Initially, you may need to refrain from eating and drinking.
- The next day, you can gradually resume eating as per the doctor's instructions.
- It is recommended to eat liquid and fibre-rich foods.
Things to note after discharge
- 如果傷口部位痛楚加劇或出現紅腫,請聯絡你的醫生或到急症室求診
- If necessary, take the painkillers prescribed by your doctor.
- 如醫生認為有需要,請完成整個抗生素療程
- Gradual return to normal activities (depending on individual circumstances)
- Avoid lifting heavy objects for the first 4 weeks.
- Avoid excessive bending and stretching of the body for the first 4 weeks.
- Please remember to return to the clinic to have your stitches/staples removed on the scheduled date. Please attend your follow-up appointment at the specialist clinic on time.
Notes
本單張只提供有關手術的基本資料,可能發生的風險或併發症不能盡錄。某類病人的風險度亦為不同。如有查詢,請聯絡你的醫生。
資料來源:https://www.ekg.org.hk/pilic/public/surgery_pilic/surgery_appendectomy_0151_chi.pdf
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