目的 探讨与比较老年急性单纯性阑尾炎与急性化脓性阑尾炎、坏疽阑尾炎或伴穿孔的发病特点、诊断要点、治疗方法选择。 方法 选取近10年我院符合急诊初诊为急性阑尾炎，年龄在70岁以上的高龄患者，共79例，按照标准，根据炎性反应轻重分两组，从术前症状、体征、相关检验、检查进行统计学比较。 结果 77例为非手术治疗或手术治疗后急性阑尾炎痊愈患者，行手术治疗患者，经病理证实诊断明确；2例为回盲部肿瘤患者，手术病理明确诊断。 结论 体温升高、右下腹反跳痛、超声诊断对于区分高龄阑尾炎严重程度具有较大意义，转移性右下腹痛和血象升高也有一定参考意义。同时应当注意同回盲部肿瘤相鉴别。

Objective To explore and compare the incidence，diagnosis and treatment between gerontal pure acute appendicitis，acute abscessing and gangrene or perforation. Methods 79 cases above 70 years old were selected whose primary diagnosis was acute appendicitis in the past decade at our hospital . They were divided into two groups by the degree of inflammation to compare symptoms、signs、blood-text and examinations. Statistic analysis was conducted. Results In the 79 cases, 77 were cured by expectant treatment or surgical operations, those who received surgeries were conformed as appenditis by pathology. The other 2 patients were finally diagnosed as ileocecus tumor by pathology. Conclusions Many methods could be used for distinguishing the degree of inflammation, in which temperature increases,  right lower part belly rebound tenderness and ultrasound examination were most important. The transfers right lower abdominal pain and the rise of blood-test could also be helpful for diagnoses. Attention should be paid to distinguishing the ileocecus tumor from appendicitis.