婴幼儿不典型阑尾炎的临床分析

Clinical analysis of atypical appendicitis in infants and babies

目的分析婴幼儿不典型阑尾炎的临床特点。方法对2004年1月～2007年12月收治的39例婴幼儿阑尾炎患儿，根据改良Alvarado评分把患儿分成不典型组及典型组，比较两组的临床特点。结果不典型组在术后病理报告、年龄分布、阑尾位置分布、B超的阴性率等有其特异性：不典型组以化脓性及坏疽穿孔阑尾炎比例高；小月龄儿多见；B超阴性率也是不典型组比例高；阑尾位置不典型组以盲肠及结肠后位多见，而典型组以盲肠下住最多。结论使用改良Alvarado评分系统诊断为不典型阑尾炎的婴幼儿应增加考虑年龄、B超、阑尾位置等因素，从而帮助更及时、准确地做出诊断和治疗。

Objectives To analyze the clinical features of infants with typical or atypical appendicitis. Methods There 39 appendicitis cases admitted to the hospital from January 2004 to December 2007 were retrospectively analyzed. Results Atypical group presented a higher proportion of pyogenic and gangrenous perforated appendicitis,more in early newborns and a higher rate in negative rate of uhrasonography. Appendix of atypical group located more in cecum and colon while that of typical group located more in inferior cecum. Conclusion Modified Alvarado Score can be assistantly make a more timely and acute diagnosis and treatment of infants with atypical appendix by considering the factors such as age, uhrasonography and appendicitis locations.