小儿肠系膜淋巴结炎472例诊治分析

Diagnosis and treatment of mesenteric lymphadenitis in children

目的:探讨小儿肠系膜淋巴结炎的诊断与治疗经验,并分析其相关问题。方法:对472例诊断为肠系膜淋巴结炎患儿进行总结、分析,探讨其发病机制、诊断标准与治疗方案。结果:本组472例患儿均以急性腹痛或反复腹痛就诊,有上呼吸道症状者占74.58%,伴有恶心呕吐者占45.55%,27例右下腹可摸到肿大的淋巴结。超声检查472例均可探及多个大小不等的低回声结节。所有病例均给予抗炎,抗病毒治疗,5～10d症状消失。随访425例,随访6d至6月,腹部B超复查肠系膜淋巴结均明显缩小,纵横径比值(L/S)小于2。结论:小儿肠系膜淋巴结炎缺乏特异性临床表现,高频彩超是首选检查方法。抗炎、抗病毒治疗有效。

Objective.. To investigation and analyze some related questions about experiences of diagnosis and treatment of mesenteric lymphadenitis in children. Methods：472 cases, who were diagnosed as mesenteric lymphadenitis, were summarized and analyze, as well as investiganted the pathogenesis, standard of diagnosis and treatment programs of mesenteric lymphadenitis. Results： 472 cases almost manifested as acute abdominal pain and recurrent abdominal pain, among of whom the upper respiratory tract infection occupied 74. 58%, accompanying by nausea and vomiting 45.55%, and 27 patients could palpable enlarging lymph node on right lower quadrant. 472 cases could be found unequal sizes hypoechoic nodules by ultrasonography. The clinic manifestations in all of patients were disappeared at 5- 10 days after anti-infective and anti-viral treatments. In 425 cases who were followed up duration from 6 days to 6 months, Abdomen ultrasound reexamination showed that their mesenteric lymph nodes were obviously reduces which ratio of the long diameter and the short diameter （L/S）of lymph nodes was less than 2. Conclusion： The clinic manifestations of the Mesenteric Lymphadenitis in children was short of specificity, while high-frequency color Doppler ultrasound could be regarded as the preferred method of examination. Anti-infective and anti-viral treatments were effective.