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目的 探讨小儿白血病并发急腹症的治疗问题。方法 对 8例小儿白血病并发急腹症的诊断、处理问题进行分析。结果 2例保守治疗后 1例缓解、1例 2个月后死于原发病 ;2例拒绝手术治疗者短期内死亡 ;4例经手术治疗 ,其中 2例术后 1周内死亡 ,另 2例术后康复 ,继续定期化疗。结论 小儿白血病并发急腹症主要表现为肠梗阻、肠坏死和肠穿孔 ,以病情重、病死率高为其特征。积极的手术治疗是挽救患儿生命的有效手段。白血病化疗可引起肠壁的广泛渗出和纤维化引起肠狭窄和肠粘连 ,导致肠梗阻、肠坏死和肠穿孔。术中发现白血病化疗可引起肠系膜血管栓塞 ,它是引起肠坏死的原因之一。
Objective To investigate the treatment of childhood acute leukemia complicated with acute abdomen. Methods Eight cases of pediatric leukemia complicated with acute abdomen diagnosis and treatment were analyzed. Results Two patients were relieved after conservative treatment and one patient died of primary disease after two months. Two patients who refused surgery died within a short period of time. Four patients were surgically treated, of whom two died within one week after surgery and the other two Cases of postoperative recovery, continue regular chemotherapy. Conclusions The main manifestations of childhood acute leukemia complicated with acute abdomen intestinal obstruction, intestinal necrosis and intestinal perforation, with severe illness and high mortality rate is characterized. Positive surgical treatment is an effective way to save children’s lives. Leukemia chemotherapy can cause extensive exudation of the intestinal wall and fibrosis cause intestinal stenosis and intestinal adhesion, resulting in intestinal obstruction, intestinal necrosis and intestinal perforation. Intraoperative findings of leukemia chemotherapy can cause mesenteric vascular embolism, which is one of the causes of intestinal necrosis.