儿童阑尾炎诊断和治疗12年经验总结  

Advances in the diagnosis and treatment of appendicitis in children: 12-year′s experience

作　　者：姜斌[1] 蒋嘉萍[1] 

机构地区：[1]南京医科大学附属南京市儿童医院小儿外科,210008

出　　处：《中华普通外科杂志》2005年第3期151-152,共2页Chinese Journal of General Surgery

摘　　要：目的　总结儿童阑尾炎临床诊断与治疗12年来的进展。方法　回顾性分析1991年1月至2 0 0 2年12月收治的2 390例儿童阑尾炎的临床病理资料。结果　本组中单纯型2 37例(9 .91% ) ;化脓型1798例(75 .2 3% ) ,合并穿孔5 6 8例(31.5 9% ) ;坏疽型2 12例(8 .81% ) ,合并穿孔15 9例(71 .36 % ) ;梗阻型14 1例(5 .89% ) ;阑尾脓肿192例(7 .4 % ) ,其中手术切除阑尾加脓肿引流2 0例(0. 83% )。本组平均穿孔率为30 . 12 % ,1岁以下17例(41 .4 6 % ) ,1～4岁2 0 1例(44 .96 % ) ,5～10岁4 0 4例(2 8. 17% ) ,10岁以上98例(2 0. 94 % )。本组患者全部治愈出院。结论　单纯型阑尾炎手术比例数与穿孔率呈反比关系,反映手术指征宽严度与诊疗水平的情况。儿童阑尾炎的穿孔率在30 %左右是可以接受的。Objective To evaluate the diagnosis and treatment of children′s appendicitis.Methods Retrospective analysis of 2390 children patients with appendicitis undergoing appendectomy, and pathological classification was made.Results The simple type was in 237 cases (9.91%); purulent in 1798 (75.23%), among which 568 (31.59%) cases suffered perforation; Gangrenous in 212 (8.87%), with perforation in 159 (71.36%).During this period, there were 192 cases (7.4%) of appandiceal abscess.The perforation rate was 30.12%.That was 41.46% in children under 1-year of age, 44.96% in 1 to 4-year of age; 28.17% in 5 to 10 year of age; and 20.94% in over 10-year of age.Conclusion The incidence of postoperative pathology-proved simple type appendicitis is in inverse proportion to that of perforation.As a whole it reflects the strictness in which an individual case is indicated for a laparotomy.It is our believe that an incidence of 30% perforation is acceptable.

关 键 词：诊断和治疗 儿童 临床病理资料 诊断与治疗 1991年 回顾性分析 阑尾炎手术 阑尾脓肿 脓肿引流 切除阑尾 诊疗水平 手术指征 单纯型 穿孔 化脓型 坏疽型 梗阻型 

分 类 号：R726.5[医药卫生—儿科]