小儿急腹征的早期诊断与手术时机的选择

目的总结小儿急腹症的早期诊断及手术治疗的经验。方法回顾性分析2003年5月～2010年7月某院普外科收治的318例小儿外科急腹症的临床资料。结果行手术治疗175例,其中3例术后切口感染,均经切口开放换药后治愈,1例阑尾周围脓肿引流术后残端瘘,保守治疗治愈,1例因急性出血性肠炎伴腹膜炎、肠坏死行肠切除术,术后因中毒性休克、脏器衰竭死亡;非手术治疗的患儿经积极保守治疗后均治愈。结论详细询问病史,细致的查体,结合必要的辅助检查是小儿急腹症早期诊断及治疗的基础;及时手术是小儿急腹症的重要治疗方法。

Early diagnosis and selection of the operation occasion on the pedo-acute abdomen

OBJECTIVE To summary the experience of early diagnosis and operation on pedo-acute abdomen.METHODS We retrospectively analyzed the clinical data on 318 pedo-patients with the actue abdomen treated in the general surgery of our hospital from May 2003 to July 2008.RESULTS 175 cases were treated by operation.Among them,3 cases had the postoperative infection,and cured by the change dressings;1 case with the periappendiceal abscess occurred the stump fistula after the operation,and cured by the expectant treatment;1 case with the acute hemorrhagic enteritis died after the intestinal resection because of the toxic shock and the MODS.Non-operation cases were all cured after the expectant treatment.CONCLUSION Detail ask the case history,micromesh medical examination,is the base of the early diagnosis and treatment for the pedo-acute abdomen;operating in time is a important treatment.