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目的探讨新生儿阑尾炎在临床中罕见发病的原因及新生儿阑尾炎的临床特点、误诊原因,以及新生儿阑尾炎早期诊断的特点。方法对郑州市儿童医院自1998年9月—2010年12月共收治新生儿阑尾炎25例,结合临床症状,查体以及辅助检查和后期的病理回示,进行综合分析。结果本组25例患儿,术后病理回示急性化脓性阑尾炎20例,坏疽性阑尾炎2例,3例为阑尾脓肿。术后并发切口感染9例,腹腔残余脓肿2例,经局部换药及抗感染治疗后,均治愈出院,无死亡。结论新生儿阑尾炎无特异症状,经常导致误诊,病死率高。但掌握了误诊原因及一些临床特点,以及严密观察患儿的病情变化,及时给予诊断及手术治疗,对可疑者应尽早剖腹探查,是减少误诊及病死率行之有效的办法。
Objective To investigate the causes of neonatal appendicitis in clinics and the clinical features of neonatal appendicitis, the causes of misdiagnosis and the characteristics of early diagnosis of neonatal appendicitis. Methods From September 1998 to December 2010, 25 children with neonatal appendicitis were admitted to Zhengzhou Children’s Hospital. Combined with clinical symptoms, physical examination, auxiliary examination and pathological retrospective analysis, a comprehensive analysis was carried out. Results The group of 25 children, postoperative pathology showed acute suppurative appendicitis in 20 cases, gangrenous appendicitis in 2 cases, 3 cases of appendix abscess. Incision infection in 9 cases after surgery, abdominal abscess in 2 cases, after local dressing and anti-infective treatment, were cured, no death. Conclusion Neonatal appendicitis no specific symptoms, often leading to misdiagnosis, high mortality. But mastered the causes of misdiagnosis and some clinical features, as well as closely observe the changes in children’s condition, timely diagnosis and surgical treatment, as soon as possible laparotomy for suspicious persons, is to reduce misdiagnosis and mortality is an effective way.