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目的分析婴幼儿不典型阑尾炎的临床特点。方法对2004年1月~2007年12月收治的39例婴幼儿阑尾炎患儿,根据改良Alvarado评分把患儿分成不典型组及典型组,比较两组的临床特点。结果不典型组在术后病理报告、年龄分布、阑尾位置分布、B超的阴性率等有其特异性:不典型组以化脓性及坏疽穿孔阑尾炎比例高;小月龄儿多见;B超阴性率也是不典型组比例高;阑尾位置不典型组以盲肠及结肠后位多见,而典型组以盲肠下位最多。结论使用改良Alvarado评分系统诊断为不典型阑尾炎的婴幼儿应增加考虑年龄、B超、阑尾位置等因素,从而帮助更及时、准确地做出诊断和治疗。
Objective To analyze the clinical features of infantile atypical appendicitis. Methods From January 2004 to December 2007, 39 infants with appendicitis in infants and young children were divided into atypical group and typical group according to modified Alvarado score. The clinical features of the two groups were compared. Results The atypical group had its specificity in postoperative pathology report, age distribution, appendix position distribution and B-ultrasound negative rate: the proportion of perinatal appendicitis with purulent and gangrene was high in atypical group; Negative rate is also a high proportion of atypical cases; appendix atypical group cecum and colon posterior more common, while the typical group to the cecum next most. Conclusions Infants and young children diagnosed with atypical appendicitis using the modified Alvarado scoring system should consider factors such as age, B-ultrasound and appendix location to help more timely and accurate diagnosis and treatment.