579例小儿急性阑尾炎的临床特点分析

目的：总结分析小儿急性阑尾炎的临床特点,为小儿急性阑尾炎诊治提供依据。方法：对2000年1月至2014年9月579例小儿急性阑尾炎患者临床各项资料进行统计分析。结果：单纯组临床表现、腹部B超检查情况与化脓组和坏疽组比较,差异均有统计学意义（P〈0.01）;而化脓组与坏疽组间比较差异也有统计学意义（P〈0.01）。多因素Logistic回归分析表明：年龄、转移性疼痛、右下腹部压痛、反跳痛、体温、白细胞总数等是影响小儿急性阑尾炎诊断的主要因素。结论：小儿急性阑尾炎临床表现不典型者诊断准确率偏低。年龄≤3岁、转移性疼痛、右下腹部压痛、反跳痛、肌紧张、体温〈37.5℃、白细胞总数〈10×10~9/L等是影响小儿急性阑尾炎诊断准确率的主要因素。

Clinical features analysis of acute appendicitis of 579 children

Objective： To summarize and analyze clinical features of acute appendicitis of children, so as to provide basis for treatment of acute appendicitis of children. Methods： The clinical data of 579 children with acute appendicitis were collected and analyzed from January 2000 - September 2014. Results： Compared the clinical manifestation and abdominal ultrasound of pure group with what of fester group and gangrene group, the difference had statistical significance （P 〈0. 01 ） ; the comparison between fester group and gangrene group also had statistical significance （P 〈0. 01 ） Multifactor logistic regression analysis showed that, the main factors influencing diagnosis of children＇s acute appendicitis were： age, metastatic pain, tenderness of lower fight abdomen, rebound pain, body temperature and total number of white blood cells, etc. Conclusion： The diagnosis accuracy rate is low for children with acute appendicitis whose clinical manifestations are not typical. The main factors influencing diagnosis accuracy rate of children acute appendicitis are： age ≤ 3 years, metastatic pain, tenderness of lower right abdomen, rebound pain, muscle tension, body temperature 〈 37. 5℃ and total number of white blood cells 〈 10 × 10^9/L, etc.