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

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。

Retrospective analysis of clinical features and ultrasonographic performance in 152 children with acute appendicitis

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 of 152 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.