超声在诊断小儿急性阑尾炎中的应用

Application of ultrasonic diagnosis in pediatric acute appendicitis

目的分析小儿急性阑尾炎超声诊断的直接、间接征象,为临床诊断提供参考。方法回顾性分析63例小儿急性阑尾炎患儿的术前超声诊断报告。结果在63例急性阑尾炎患儿中,有44例超声检查表现出明确的阑尾炎直接征象;13例超声检查有间接征象,其中9例超声提示右下腹有混合回声包块,3例超声提示右下腹肠壁水肿、腹腔积液,1例超声提示气体多层反射回声;还有6例超声检查未见明显异常。结论小儿急性阑尾炎的超声诊断中,间接征象与直接征象同样重要,应根据患儿的个体特征,做到超声直接征象与间接征象相结合进行,并注意总结、积累临床经验,以有效提高诊断率。

Objective To analyze direct and indirect signs by ultrasonic diagnosis in pediatric acute appendicitis, and to provide reference for clinical diagnosis. Methods A retrospective analysis was made on preoperative ultrasonic diagnosis reports of 63 children patients with pediatric acute appendicitis. Results Among 63 acute appendicitis children, there were 44 cases with clear direct signs of appendicitis, 13 cases with indirect signs shown by ultrasonic examination, along with right lower quadrant mixed echo enclosed mass in 9 cases, right lower quadrant intestinal wall edema and seroperitoneum in 3 cases and gas multilayer reflection echo in 1 case, and 6 cases without obvious abnormality in ultrasonic examination. Conclusion In ultrasonic diagnosis of pediatric acute appendicitis, both direct and indirect signs contain importance. Combination of direct and indirect signs is necessary, in accordance with individual features of children patients. Summarization and accumulation of clinical experience are essential for improving diagnosis rate.