小儿胆囊炎胆石症21例临床分析

Clinical Analysis on 21 Cases of Children Cholecystitis Cholelithiasis

[目的]探讨小儿胆囊炎胆石症的临床特点、诊断与治疗方法。[方法]回顾性总结14年间收治的小儿胆囊炎胆石症21例的临床资料,对其临床特点、诊疗方法以及随访资料进行分析。[结论]门诊首诊为胆囊炎12例,误诊率为42.86%。其中7例施行手术治疗,病理检查提示急性胆囊炎5例,慢性胆囊炎2例;胆固醇结石5例,混合性结石2例。2例拒绝手术者经保守治疗症状好转后出院。12例无胆石症的急性单纯性胆囊炎患儿给予短期禁食、纠正水电解质失衡、抗感染、解痉、利胆等治疗,住院10～21d治愈出院。[结论]小儿胆囊炎胆石症发病率低,缺乏典型症状,临床易误诊,诊断明确后应及时治疗。

[Objective]To discuss the clinical features, diagnosis and treatment of children cholecystitis cholelithiasis, [Method] Trace back and sum up 21 cases in 14 years, make analysis on their clinical features, diagnosis and treatment and follow-up data. [Result]12 cases of first diagnosis of cholecystitis, the misdiagnosis rate 42.86%; among which, 7 were operated, whose patho logical exam showed 5 cases of acute cholecystitis and 2 chronic one; 5 cholesterol gallstone, 2 mixed gallstone; 2 refused operation and were better after preserved treatment then left hospital, 12 cases of acute pure cholecystitis, without cholelithiasis, were fast- ing for short time, correcting unbalanced electrolyte, anti infection, removing spasm, relieving gallbladder, and left hospital after being 10-21d in hospital and cured. [Conclusion]There＇s low occurrence rate of children cholecystitis cholelithiasis, lacking typical symptoms, easily causing misdiagnosis; in time treatment shall be made after correct diagnosis.