论文部分内容阅读
婴幼儿急性阑尾炎发病率虽低,但极易误诊,易穿孔,死亡率高。我科自1989～1995年共收治婴幼儿急性阑尾炎32例。本文就其临床特点结合病例并参考有关文献作一下分析。 1 临床资料 男20例,女12例。均为5岁以内,1岁以内发病者少见,本组仅1例,为6月龄婴儿。随年龄增加,发病率逐渐增高。 本组除1例为转移性右下腹痛外,其余腹痛均不典型。其中发热25例,体温在37.5℃～40℃,38℃以上16例。恶心呕吐27例,部分病例为频吐或拒食。便秘8例,稀水样腹泻6例。右下腹或下腹部固定压痛32例,肌紧张18例。白细胞总数大多升高,在15～20×10~(9)/L中性粒细胞在75%～95%之间。 2 治疗方法与结果 本组病例除2例入院时已确诊为阑尾脓肿采用保守治疗治愈出院外,其余均行手术治疗。在30例手术病人中,证实单纯性阑尾炎4例(13.3%),化脓、坏疽性阑尾炎26例(86.6%;其中有16例已发生穿孔,穿孔率为53.3%。木后并发症有:切口感染3例(10%),粘连性肠梗阻2例(6.6%),盆腔脓肿1例(3.3%)。全部病例均治愈出院。
Although the incidence of acute appendicitis in infants and young children is low, but extremely misdiagnosed, easy to perforation, high mortality. Our department from 1989 to 1995, a total of 32 cases of acute appendicitis infants admitted. In this paper, the clinical characteristics of patients with reference to the case and make some analysis. A clinical data of 20 males and 12 females. Are less than 5 years of age, less than 1-year-old onset were rare, this group only 1 case, 6-month-old baby. With age, the incidence gradually increased. In addition to a group of patients with metastatic right lower abdominal pain, the other abdominal pain are not typical. Including 25 cases of fever, body temperature 37.5 ℃ ~ 40 ℃, 38 ℃ above 16 cases. Nausea and vomiting in 27 cases, some cases of frequent vomiting or antifeedant. Constipation in 8 cases, watery diarrhea in 6 cases. Right lower quadrant or lower abdomen fixed tenderness in 32 cases, muscle tension in 18 cases. Most of the total number of white blood cells increased in 15 ~ 20 × 10 ~ (9) / L neutrophils in between 75% to 95%. 2 treatment methods and results in this group of patients in addition to two cases admitted to hospital has been diagnosed as appendix abscess cured by conservative treatment, discharged, the rest were surgery. Among 30 surgical patients, pleural and gangrenous appendicitis were confirmed in 4 patients (13.3%), purulent and gangrenous appendicitis in 26 patients (86.6%; 16 of them had perforation and the perforation rate was 53.3% Infected 3 cases (10%), adhesive intestinal obstruction in 2 cases (6.6%), pelvic abscess in 1 case (3.3%) .All patients were cured and discharged.