小儿美克尔憩室的诊断及治疗分析

Diagnosis and treatment of pediatric Meckel's diverticulum

目的探讨小儿美克尔憩室的术前诊断及手术治疗结果。方法回顾性分析64例手术病理证实为美克尔憩室患儿术前高锝酸盐及超声检查差异,便血与病理的关系,术后并发症情况。结果术前34例行99 m Tc-高锝酸盐放射性核素扫描显像,64例行超声检查,阳性率分别为55. 88%与67. 18%,差异无统计学意义(P> 0. 05)。便血组与未便血组患儿术后异位胃黏膜组织病理检查阳性率分别为87. 80%与30. 43%,差异有统计学意义(P <0. 05),腹腔镜与开腹手术术后并发症差异无统计学意义(P> 0. 05)。结论 99 m Tc-高锝酸盐放射性核素显像与超声是小儿美克尔憩室诊断的重要检查方法;异位胃粘膜组织与患儿便血密切相关;美克尔憩室患儿手术后恢复普遍较好,并发症少。

To investigate the diagnosis and surgical treatment results of pediatric Meckel s diverticulum.We retrospectively analyzed the difference between preoperative 99 m Tc-high technetium radioactive nuclide scan and ultrasound examination in 64 cases with Meckel s diverticulum confirmed by pathology after the surgery.The relationship of hemafecia with pathology and postoperative complications were also analyzed.Of the 64 patients,34 underwent high technetium radioactive nuclide scan and 64 underwent high frequency ultrasound diagnosis preoperatively.The diagnose accordance rate was 55.88%and 67.18%,respectively.The difference between the two methods was not significant(P>0.05).The positive rates of ectopic gastric mucosa tissue in the hemafecia and non-hemafecia groups were 87.80%and 30.43%,respectively.The difference was significant(P<0.05).No significant difference in postoperative complications was found between laparoscopic surgery and laparotomy(P>0.05).99 m Tc-high technetium radioactive nuclide imaging and ultrasound are the important methods for the diagnosis of pediatric Meckel s diverticulum.Ectopic gastric mucosa is closely related to children s hemafecia.The recovery of pediatric Meckel s diverticulum after surgery is generally good with fewer complications.