13例小儿急性阑尾炎穿孔误诊分析

The Analysis of 13 Children with Acute Perforated Appendicitis Misdiagnosis

目的分析小儿急性阑尾炎穿孔误诊原因,以降低小儿急性阑尾炎穿孔的误诊率,减少术后并发症及阑尾炎穿孔误诊的发生,增加医患之间信任度,减少医患矛盾。方法回顾本院近3年收治的87例急性阑尾炎患儿中13例误诊病例的临床资料,对病史、体征、相关检查结果、手术所见,进行回顾性统计研究,分析误诊原因。结果在13例误诊病例中,入院疑似诊断为阑尾炎5例、后经手术证实为阑尾穿孔;入院诊断为其他疾病,经过治疗无好转,从而行必要的手术探查证实为阑尾穿孔8例。结论对小儿急性阑尾炎穿孔的临床症状、特点,缺乏足够的认识,腹部体征的掌握不准确及过多依赖辅助检查是误诊的主要原因。

Objective To Analyze misdiagnosis reason of acute appendicitis perforation, reduce the misdiagnosis rate of acute appendicitis perforation, reduce the incidence of postoperative complications and perforated appendi- citis misdiagnosis, increase the degree of doctor - patient trust, and reduce the doctor - patient conflicts. Methods Review the clinical data of 13 misdiagnosed cases in 87 acute appendicitis children admitted to hospital in nearly three years. Make the retrospective statistical research for their clinical history, signs, related test results, and op- erative findings and analyze the causes of misdiagnosis. Results In 13 cases of misdiagnosed cases, 5 cases were admitted to hospital with suspected diagnosis of appendicitis, then confirmed perforated appendix by surgery ; 8 ca- ses were admitted with other diseases, do not improve after treatment, then confirmed perforated appendix by nec- essary surgical exploration. Conclusion The lack of sufficient knowledge of the clinical symptoms characteristic of acute appendicitis perforation, inaccurate grasp of abdominal signs and excessive dependence on the auxiliary ex- amination is the main cause of misdiagnosis.