小儿Amyand’s疝18例临床分析  

Clinical analysis of Amyand＇ s hernia in children by 18 cases

作　　者：杨坤[1] 吉磊[1] 张建军[1] 

机构地区：[1]湖北省孝感市中心医院小儿外科,湖北省孝感市432100

出　　处：《临床小儿外科杂志》2012年第1期23-24,共2页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨小儿Amyand’s疝（Amyand’s hernia，AH）的临床特点及治疗方法，提高诊治水平。方法回顾性分析2004年1月至2010年12月作者收治的18例AH患儿的临床资料。结果18例患儿中，男性17例，女性1例，中位年龄1．2岁（23d至5岁3个月）。临床特点：腹股沟区肿块18例，呕吐11例，发热10例；9例白细胞增高；5例腹部X线检查显示肠梗阻；3例彩超可见阑尾“双边”影，2例见条索状低回声。治疗方法：10例因合并阑尾炎，行疝囊高位结扎术时一并切除阑尾；8例仅行疝囊高位结扎术。18例均痊愈出院。术后病理检查提示单纯性阑尾炎5例，化脓性阑尾炎3例，坏疽性阑尾炎2例。结论小儿AH临床少见，I型AH处理上跟一般嵌顿疝相同，将阑尾直接还纳入腹腔；Ⅱ、Ⅲ型AH则需行阑尾切除。根据术中情况正确处理不同类型的AH，一般均可取得较好的疗效。Objective To explore the clinical features and therapy of Amyand＇ s hernia. Methods Review the clinical meterial of 18 cases with AH from January 2004 to december 2010 in our hospital. Re- suits There were 17 boys, lgirls in the study, the median age was 1.2 years（23 days to 5 years and 3 months）. The clinical symptom was swelling of inguinal region （18 cases）, vomiting（ 11 cases） and fever （10cases）. 9 cases presented with elevated WBC; 9 cases showed intestinal obstruction with X-ray; there were abnormal findings in 5 cases with color Doppler ultrasonography. Hernia repair without an appendectomy was performed in patients with normal appendix. Emergency appendectomy through herniotomy was performed in ca- ses of infamed and perforated appendices. Conclusion Amyand＇ s hernia is rare, the treatment of type I Amyand＇ s hernia is the same as generally incarcerated hernia; type II and type 11I Amyand＇ s hernia are trea- ted by appendectomy through herniotomy.

关 键 词：疝 腹股沟 阑尾切除术 儿童 

分 类 号：R726.562.1[医药卫生—儿科]