小儿急性阑尾炎临床诊疗分析

Analysis on clinical diagnosis and treatment of children acute appendicitis

目的:总结小儿阑尾炎的临床诊疗,及时做出临床诊断与手术治疗,减少术后并发症的发生。方法:对本院6年来外科手术治疗的56例小儿急性化脓穿孔性阑尾炎临床资料进行回顾性分析。结果:56例均行手术治疗,其中化脓性阑尾炎22例,坏疽、穿孔性阑尾炎28例,阑尾周围脓肿6例,首发症状以腹泻为主8例,以感冒发热为主7例,以肠梗阻为主5例,术前诊断与术后诊断均为阑尾炎者40例,符合率为71.4%。术前诊断与术后诊断不相符16例,误诊率28.6%。并发症有切口感染7例,肺部感染5例,腹腔残余感染4例,肠梗阻3例,粪瘘1例,腹膜裂开2例。结论:详细了解病史、仔细体格检查、合理运用辅助诊断及综合分析可避免延误诊断及治疗,减少术后并发症的发生。

Objective：To summarize the clinical experiences of diagnosis and treatment of children appendicitis for taking the clinical diagnosis and operative treatment in time to reduce the occurrence of postoperative complications.Methods：The clinical data in 56 children cases of acute suppurative and perforating appendicitis in the past 6 years were retrospectively analyzed.Results：All the 56 cases got operative treatment.Among them,22 cases were suppurative appendicitis,28 cases gangrenous perforation and 6 cases periappendiceal abscess.The first symptoms were mainly diarrhea in 8 cases,cold and fever in 7 cases and intestinal obstruction in 5 cases.40 cases were diagnosed as children acute appendicitis either before operation or after operation with the coincidence rate of 71.4%.16 cases got inconsistent diagnosis between before operation and after operation with the misdiagnosis rate of 28.6%.Complications were incision infection in 7 cases,lung infection in 5 cases,residual infection of abdominal cavity in 4 cases,intestinal obstruction in 3 cases,manure fistula in 1 case and peritoneal split in 2 cases.Conclusion：Through inquiring about the history of disease in great detail,careful medical check-up,making proper use of auxiliary diagnosis,and comprehensive analyses,the treatment delay and mistreatment may be avoided,and postoperative complications will be reduced.