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目的探讨儿童不典型进展期阑尾炎的临床特点。方法回顾性的调查2002年1月~2004年8月415例进展期阑尾炎,根据改良Alvarado评分把患儿分成不典型组、疑似组、典型组三组,比较各组之间的临床特点,总结不典型的进展期阑尾炎的临床特点。结果不典型组与典型组患儿之间在年龄分布、肥胖的有无、阑尾位置分布之间有一定的差异性。不典型组4岁以下儿童比例相对较高;肥胖的患儿比例相对较高;它们在阑尾位置分布上是有差别的,典型组以回肠前和盆位为主,而不典型组以盲肠后以及回肠后为主。结论儿童进展期阑尾炎的不典型表现与患儿的低龄、肥胖及阑尾位置有关,单纯使用建立在临床症状基础上的评分系统,可能会延误这些患儿的治疗。
Objective To investigate the clinical features of children with atypical advanced appendicitis. Methods A retrospective investigation of 415 patients with advanced appendicitis from January 2002 to August 2004 was performed. According to the modified Alvarado score, the children were divided into three groups: atypical group, suspected group and typical group. The clinical features of the patients were compared and the clinical features were summarized. Clinical characteristics of atypical advanced appendicitis. Results between atypical group and typical group of children in the age distribution, presence of obesity, there is a certain difference between the distribution of appendix. Atypical group of children under the age of 4 relatively high proportion; obese children a relatively high proportion of their appendix position distribution is different, the typical group of ileum and pelvic predominant, while atypical group with cecum And the main ileum. Conclusions The atypical appearence of children with progressive appendicitis is related to the age, obesity and appendix position of children. Simply using the scoring system based on clinical symptoms may delay the treatment of these children.