儿内科急性阑尾炎诊治探讨

目的 探讨儿内科小儿急性阑尾炎的诊治特点。方法 对儿内科就诊的79例急性阑尾炎病例进行回顾性分析。结果 首次于儿内科就诊的79例急性阑尾炎病儿，均于就诊后24h内转入儿外科治疗，临床以腹痛、发热、末梢血白细胞及中性粒细胞增高为主要表现。74例经手术治疗后证实为急性阑尾炎，其中化脓性阑尾炎45例，坏疽性阑尾炎12例，蛔虫性阑尾炎1例，单纯性阑尾炎16例。36例发生阑尾穿孔，21例并发弥漫性腹膜炎。5例未手术治疗。结论 首次于儿科内科就诊的腹痛患儿，伴有发热、周围血白细胞或／和中性粒细胞增高，尤其有右下腹固定压痛者，鉴别除外儿内科常见腹痛性疾病，应考虑阑尾炎，并及时与儿外科医生联系，早期诊断，及时处理，减少并发症。

The Analysis of Pediatric Acute Appendicitis

Objective To evaluate the diagnosis and treatment of acute appendicitis in children. Methods The data of 79 children with acute appendicitis, who were treated firstly at the Department of Pediatrics, were reviewed and analyzed. Results All the 79 children with acute appendicitis were transferred to the Department of Pediatric Surgery within 24 hours after admission. Main manifestations include fever,abdominal pain, increased white blood cell counts and neutrophils in peripheral bleod.74 of the 79 cases were confirmed to be acute appendicitis through surgical operation. Among them, pyogenic were 45, necrnfic 12,simplex 16 and 1 case caused by round worm. Perforation occurred in 36 cases and general peritonitis in 21 cases. Other 5 cases were not operated. Conclusions When children came to the pediatric clinic with abdominal pain, fever and increased white blood cell counts in peripheral blood, especially with tenderness constantly over the lower right quadrant of the abdomen, the diagnosis of acute appendicitis should be considered, Once other pediatric diseases with abdominal pain were excluded, the patient should consult a pediatric surgeon immediately, so that the disease can be diagnosed and treated in time, and severe complications can be decreased.