儿童急性阑尾炎的超声诊断

目的探讨超声检查在儿童急性阑尾炎诊断中的应用价值。方法对246例临床疑为急性阑尾炎的患儿予以急诊腹部B超检查。通过测量阑尾外径,观察阑尾腔内容物,阑尾壁有无充血,以及阑尾周围情况等来判断是否存在阑尾炎。结果246例急性腹痛患儿中,114例超声诊断为急性阑尾炎,其中97例急诊手术切除阑尾,另17例阑尾脓肿予非手术治疗,于6个月后择期手术。术后病理均证实诊断无误。余132例患儿中121例肠系膜淋巴结炎,6例卵巢囊肿,1例胆总管囊肿,1例肠系膜囊肿,2例右肾积水,1例右侧输尿管结石。肠系膜淋巴结炎患儿予非手术治疗,其中103例好转,18例因症状不消失仍施以阑尾切除术,病理报告5例为化脓性阑尾炎,13例为单纯性阑尾炎。结论超声检查在儿童急性阑尾炎的诊断中有实用价值。

Effect of ultrasound on diagnosis of children's acute appendicitis

Objective To investigate the effect of ultrasound on diagnosis of acute appendicitis. Methods Emergency examination of ultrasound were performed on 246 children who had been suspected with acute appendicitis. Outer diameters of the appendix was measured, appendiceal lumen and hyperemia within the appendiceal wall and surroundings of the appendix were determined. Results Two hundred and forty-six children who were suspected of having acute appendicitis were underwent ultrasound. One hundred and fourteen children were diagnosed of appendicitis by ultrasound. Among them, 97 children had appendectomy, and the other 17 children had delayed appendectomy six mothers later for the reason of appendix mass. All of the diagnosis were confirmed by pathologists. Among the rest 132 children, 6 children were diagnosed of bleeding of ovarian cyst, while one was choledochal cyst, one was mesenteric cyst, two were right - hydronephrosis, and one was right - uretemlith, One hundred and twenty-one children were diagnosed of mesenteric lymphadenitis and treated conservatively. One hundred and three of the 121 children recovered, appendectomy were performed on 18 children, five of them were diagnosed of suppurative appendicitis, and 13 of them were diagnosed of pure appendicitis. Conclusion Combined with symptoms and signs, ultrasound is valuable on diagnosing patients of acute appendicitis.