152例小儿急性阑尾炎的临床特征及超声表现的回顾性分析
|
摘要
目的回顾性分析152例小儿急性阑尾炎病例以探讨其临床特征及彩色超声多普勒检查在小儿急性阑尾炎中的诊断价值。方法选取2016年1月～2018年6月期间在我院儿外科接受阑尾手术治疗的152例急性阑尾炎患儿作为研究对象,所有患儿超声检查前均对其进行临床病史的询问,然后采右下腹髂血管定位法、回盲部定位法两种不同的方法追踪阑尾,均进行手术和病理诊断确定为急性阑尾炎。结果急性阑尾炎患儿具有腹痛病史明显高于没有腹痛病史,具有先腹痛后发热特点的患儿明显高于先发热后腹痛特点的患儿。通过回盲部定位法阑尾的显示率大大提高。术中探查及病理诊断阑尾炎的发病诱因,粪石梗阻为主要发病原因。本组病例小儿急性阑尾炎的超声诊断率为86.8%。漏诊或误诊20例。结论超声检查前仔细询问患儿临床病史、进行简单体格检查,超声检查时通过回盲部定位法扫查阑尾,对阑尾及其周围超声图像仔细辨认,可以提高急性阑尾炎超声诊断率,为临床提供重要依据。
Objective To retrospectively analyze 152 cases of acute appendicitis in children to explore its clinical features and the diagnostic value of color Doppler ultrasonography in children with acute appendicitis. Methods A total of152 children with acute appendicitis who underwent appendectomy in the Department of Pediatric Surgery of our hospital from January 2016 to June 2018 were enrolled. All children were asked for clinical history before ultrasound examination. Then, the right lower quadrant vascular positioning method and ileocecal localization method were used to track the appendix. All children were diagnosed with acute appendicitis by surgery and pathology. Results The proportion of patients with acute appendicitis who had a history of abdominal pain was significantly higher than that without the history of abdominal pain. Children with fever after first abdominal pain were significantly more than those with abdominal pain after first fever. The display rate of the appendix was greatly improved by the holster positioning method. The causes of appendicitis were explored during operation and by pathological diagnosis. The fecal stone obstruction was the main cause of the disease. The ultrasound diagnosis rate of acute appendicitis in children in this group was 86.8%. And there were 20 cases of missed diagnosis or misdiagnosis. Conclusion Before the ultrasound examination, the clinical history of the child is carefully inquired, and the simple physical examination is performed. The appendix is scanned by ileocecal positioning method during ultrasound examination. The ultrasound image of the appendix and its surroundings is carefully identified, which can improve the ultrasound diagnosis rate of acute appendicitis and provide an important basis for clinical.
Objective To retrospectively analyze 152 cases of acute appendicitis in children to explore its clinical features and the diagnostic value of color Doppler ultrasonography in children with acute appendicitis. Methods A total of152 children with acute appendicitis who underwent appendectomy in the Department of Pediatric Surgery of our hospital from January 2016 to June 2018 were enrolled. All children were asked for clinical history before ultrasound examination. Then, the right lower quadrant vascular positioning method and ileocecal localization method were used to track the appendix. All children were diagnosed with acute appendicitis by surgery and pathology. Results The proportion of patients with acute appendicitis who had a history of abdominal pain was significantly higher than that without the history of abdominal pain. Children with fever after first abdominal pain were significantly more than those with abdominal pain after first fever. The display rate of the appendix was greatly improved by the holster positioning method. The causes of appendicitis were explored during operation and by pathological diagnosis. The fecal stone obstruction was the main cause of the disease. The ultrasound diagnosis rate of acute appendicitis in children in this group was 86.8%. And there were 20 cases of missed diagnosis or misdiagnosis. Conclusion Before the ultrasound examination, the clinical history of the child is carefully inquired, and the simple physical examination is performed. The appendix is scanned by ileocecal positioning method during ultrasound examination. The ultrasound image of the appendix and its surroundings is carefully identified, which can improve the ultrasound diagnosis rate of acute appendicitis and provide an important basis for clinical.
引文
[1]赵艳梅,范敏.小儿急性阑尾炎诊治分析[J].河南大学学报(医学版),2006,25(2):53-54.
[2]王岩,张媛,左忠义,等.超声诊断小儿急性阑尾炎55例分析[J].中国误诊学杂志,2008,8(3):670-671.
[3]王小林,袁继炎.小儿阑尾炎诊治进展[J].中华小儿外科杂志,2004,25(2):185-187.
[4]李振春.小儿急性阑尾炎的诊断体会[J].中国民族民间医药,2009,18(20):92.
[5]贾立群,王晓曼.实用儿科腹部超声诊断学[M].北京:人民卫生出版社,2009:198-199.
[6]蔡盈,史德利,刘淑娟.小儿阑尾炎术后早期炎性肠梗阻23例临床护理[J].齐鲁护理杂志,2012,18(9):78-79.
[7]Toprak H,Kilincaslan H,Ahmad IC,et al.Integration ofultrasound findings with alvarado score in children with sus-pected appendicitis[J].Pediatt Int,2014,56(1):95-99.
[8]杨佳丽,梁淑仪,洪碧珊,等.小儿阑尾炎声像图特征及其分型价值研究[J].山西医药杂志,2017,6(46):650-652.
[9]王晓红,李京亮,易贤林,等.彩色多普勒超声对急性阑尾炎的诊断价值及漏诊原分析[J].山西医药杂志,2015,44(14):1606-1609.
[10]程映雪,范怀周.彩色多普勒超声对小儿急性阑尾炎临床价值[J].当代医学,2010,16(18):92-93.
[11]葛郁荣,周艳.彩色多普勒超声在60例小儿阑尾炎诊断中的应用价值[J].贵州医药,2016,40(7):773-774.
[12]李立平.超声诊断小儿急性阑尾炎的临床价值分析[J].中外医学研究,2016,14(9):88-89.
[13]冯永福,邓建群,郭文招,等.彩色多普勒超声诊断小儿急性阑尾282例分析[J].中国当代医药,2008,15(24):97-98.
[14]林淑莲,蒋双兰,卜秋强,等.小儿暂时性小肠套叠的超声特征及临床特点分析[J].中国当代医药,2017,24(19):139-141.
[15]汤文芳.超声检查对小儿阑尾炎的诊断和分型的临床价值[J].临床医学,2016,36(7):29-30.
[16]陈秋妍,张建飞,张巧仪,等.超声检查在小儿阑尾炎临床诊断中的应用[J].中国民康医学,2014,26(16):54-56.
[17]李宏英.高频彩色多普勒超声在小儿急性阑尾炎诊断中的临床价值[J].黑龙江医药,2014,27(3):687-689.
[2]王岩,张媛,左忠义,等.超声诊断小儿急性阑尾炎55例分析[J].中国误诊学杂志,2008,8(3):670-671.
[3]王小林,袁继炎.小儿阑尾炎诊治进展[J].中华小儿外科杂志,2004,25(2):185-187.
[4]李振春.小儿急性阑尾炎的诊断体会[J].中国民族民间医药,2009,18(20):92.
[5]贾立群,王晓曼.实用儿科腹部超声诊断学[M].北京:人民卫生出版社,2009:198-199.
[6]蔡盈,史德利,刘淑娟.小儿阑尾炎术后早期炎性肠梗阻23例临床护理[J].齐鲁护理杂志,2012,18(9):78-79.
[7]Toprak H,Kilincaslan H,Ahmad IC,et al.Integration ofultrasound findings with alvarado score in children with sus-pected appendicitis[J].Pediatt Int,2014,56(1):95-99.
[8]杨佳丽,梁淑仪,洪碧珊,等.小儿阑尾炎声像图特征及其分型价值研究[J].山西医药杂志,2017,6(46):650-652.
[9]王晓红,李京亮,易贤林,等.彩色多普勒超声对急性阑尾炎的诊断价值及漏诊原分析[J].山西医药杂志,2015,44(14):1606-1609.
[10]程映雪,范怀周.彩色多普勒超声对小儿急性阑尾炎临床价值[J].当代医学,2010,16(18):92-93.
[11]葛郁荣,周艳.彩色多普勒超声在60例小儿阑尾炎诊断中的应用价值[J].贵州医药,2016,40(7):773-774.
[12]李立平.超声诊断小儿急性阑尾炎的临床价值分析[J].中外医学研究,2016,14(9):88-89.
[13]冯永福,邓建群,郭文招,等.彩色多普勒超声诊断小儿急性阑尾282例分析[J].中国当代医药,2008,15(24):97-98.
[14]林淑莲,蒋双兰,卜秋强,等.小儿暂时性小肠套叠的超声特征及临床特点分析[J].中国当代医药,2017,24(19):139-141.
[15]汤文芳.超声检查对小儿阑尾炎的诊断和分型的临床价值[J].临床医学,2016,36(7):29-30.
[16]陈秋妍,张建飞,张巧仪,等.超声检查在小儿阑尾炎临床诊断中的应用[J].中国民康医学,2014,26(16):54-56.
[17]李宏英.高频彩色多普勒超声在小儿急性阑尾炎诊断中的临床价值[J].黑龙江医药,2014,27(3):687-689.