小儿网膜囊肿21例临床分析

目的 探讨小儿网膜囊肿临床表现及诊治要点.方法 回顾性分析1994～2007年我院经手术及病理证实21例小儿网膜囊肿临床表现、诊断及治疗资料.结果 男女比例大致相等.发病年龄3岁以内52.4%,6岁以内76.2%,10岁以内95.2%.腹胀、腹块、贫血、腹痛、呕吐是本病主要临床特点.全组入院诊断符合率38.1%,误诊为腹水待查(19.1%)、肠系膜囊肿(14.3%)及中度以上贫血待查(14.3%).CT检查57.1%,诊断符合率83.3%;腹部X线平片检查19.1%,诊断符合率25.0%;B超检查90.5%,诊断符合率78.9%.囊肿位于大网膜80.9%,小网膜19.1%.行囊肿完整切除术90.4%,囊肿大部分切除、残余与血管粘连处囊肿内表面用碘酊烧灼9.6%.结论 10岁以内儿童有腹胀、腹块、贫血表现者应警惕本病可能.B超和CT检查诊断价值高,手术治疗作为首选.近期随访疗效满意,8年随访15例(71.4%)无复发.

Clinical analysis of omental cysts in children

Objective To study the clinical diagnostic and treatment features of omental cysts in clildren. Methods Clinical diagnostic and treatment data of 21 patients with omental cysts in children were reviewed retrospectively. Results Morbidity rate between male and female was almost equal. Rate of attacking age was 52.4% under 3 years, 76.2% under 6 years and 95.2% under 10 years. Distension, mass of abdomen and anemia were the main clinical situations. The diagnostic accuracy rate was 38.1%, and the misdiagnosis rate to hydroperitoneum, mesenteric cysts and moderate anemia was 19.1%, 14.3 % and 14.3 % respectively at admission. 57.1% patients were checked by CT. The accuracy rate was 83.3%. 19.1% patients were checked by plain film of abdomen. The accuracy fate was 25.0%. 90.5% patients were checked by ultrasound. The accuracy rate was 78.9%. 80.90% and 19.1% omental cysts were located in greater omentum and lesser omentum respectively. 90.6% patients were conducted with cyst resection singly. 9.4% patients were conducted with half-baked cyst resection, and the surface on intra-cyst and vessel adhesion was treated with iodine tincture. Conclusion Children under 10 years who have the presenting features of abdominal distension, mass and anemia should be suspected of omental cysts. Ultrasound and CT are the most valuable methods for diagnosis. Operation is the first choice of cure, and the effect of therapy is satisfied. There were no sign of relapse in 15 cases after 8 years of follow-up.