2例新生儿阑尾炎报告并文献复习  

Two Cases of Neonatal Appendicitis and Literature Review

作　　者：黄雪霏 黄栩栩 李萍萍 韦红[1] Huang Xuefei;Huang Xuxu;Li Pingping;Wei Hong(Children’s Hospital of Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院,重庆400014

出　　处：《儿科药学杂志》2020年第7期13-16,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨新生儿阑尾炎的临床特点,提高临床诊治成功率和改善预后。方法:总结分析我院2例新生儿阑尾炎诊疗情况,并结合全国1980年1月至2018年9月主要中文数据库中收录的新生儿阑尾炎321例报告进行文献复习。结果:包括本文报道的2例,国内1980年1月至2018年9月共报道323例新生儿阑尾炎,男女比例2.3∶1,主要临床表现为发热、腹胀、呕吐、拒乳及反应差,查体以腹部压痛、腹胀、肠鸣音改变为主。初始诊断新生儿阑尾炎仅61例(18.9%),腹部彩超可见阑尾及其周围病变、右下腹包块、腹腔积液,分别占26.9%、25.6%、19.9%;304例(94.1%)行手术治疗,85.4%治愈,3.1%好转,6.5%死亡,5.0%失访。结论:新生儿阑尾炎缺乏特异的症状和体征,早期诊断困难,腹部彩超改变较为特异,因此需对临床症状及影像学进行综合分析,从而早期诊断,及时手术治疗,降低新生儿阑尾炎的病死率。Objective:To investigate the clinical characteristics of neonatal appendicitis,and to improve the success of clinical diagnosis and treatment and prognosis.Methods:The clinical data of two cases of neonatal appendicitis in our hospital were summarized and analyzed,and literature review was performed based on reports of 321 cases of neonatal appendicitis from the main Chinese database from Jan.1980 to Sept.2018.Results:From Jan.1980 to Sept.2018,a total of 323 cases of neonatal appendicitis were reported in China,including 2 cases reported in this thesis,with the male to female ratio of 2.3∶1.The main clinical manifestations were fever,abdominal distension,vomiting,milk rejection,and poor response.Physical examination was mainly about abdominal tenderness,abdominal distension and changes in bowel sounds.Only 61 cases(18.9%)of neonatal appendicitis were initially diagnosed,abdominal ultrasonography showed appendicitis and its surrounding lesions,right lower abdominal mass and peritoneal effusion,accounting for 26.9%,25.6%and 19.9%,respectively.Totally 304 cases(94.1%)underwent surgical treatment;and 85.4%were cured,3.1%improved,6.5%died,and 5.0%were lost to follow-up.Conclusion:Neonatal appendicitis lacks specific symptoms and signs,early diagnosis is difficult,and abdominal ultrasonography changes are more specific.Therefore,comprehensive analysis of clinical symptoms and imaging is needed for early diagnosis and timely surgical treatment,so as to reduce the mortality rate of neonatal appendicitis.

关 键 词：急性阑尾炎 新生儿 文献复习 

分 类 号：R722.1[医药卫生—儿科]