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1、小儿急性阑尾炎临床诊治分析黄先(贵州省剑河县人民医院外科，贵州剑河556400)摘要：目的通过总结小儿阑尾炎的临床诊治经验，及时做出临床诊断与手术治疗，减少术后并发症的发生。方法对该院6年来外科手术治疗的76例小儿急性化脓穿孔性阑尾炎进行回顾性分析和总结。结果本组76例均行手术治疗，其中化脓性阑尾炎18例，坏疽、穿孔性阑尾炎20例，阑尾周围脓肿5例，首发症状以腹泻为主要的有6例，以感冒发热为主要的有6例，以肠梗阻为主要的有4例，术前诊断与术后诊断均为阑尾炎者32例，符合率为74.4%。术前诊断与
2、术后诊断不相符11例，误诊率25.6%。并发症有切口感染6例，肺部感染5例，腹腔残余感染6例，肠梗阻3例，粪痿1例，腹膜裂开1例。结论通过详细了解病史、仔细体格检查、合理运用辅助诊断、综合分析可能避免延误诊断及治疗，减少术后并发症的发生。关键词：小儿阑尾炎；化脓；穿孔；诊断Clinicaldiagnosisanalysisofchildren^acuteappendicitisHuangXian(DepartmentofGeneralSurgery,JianhePeople'sHospital,
3、Jianhe,Guizhou556400)Abstract:AimToreviewclinicaldiagnosisexperiencesofcuringchildren'sappendicitis,andrecommendthatdiagnosisandoperativetreatmentshouldbemadeintimetoreducecomplicationsafteroperation.Methods76casesofchildren'sacuteappendicitiswereana
4、lyzedandsummarizedretrospectively.Thosechildrenhadbeendiagnosisandoperativelytreatedinthepastsixyears.ResultsAllthe76casesgotoperativetreatment,amongwhich18casesweresuppurativeappendicitis,20casesgangrenousperforation,and5casesappendixabscess・Origina
5、lsymptomsrangedfrom6caseswithdiarrhoea,6caseswithfluandfever,to4caseswithintestinalobstruction.32caseswerediagnosedaschildren'sacuteappendicitiseitherbeforeoperationorafteroperation.Therateofcorrectdiagnosiswas74.4%.11casesgotinconsistentdiagnosisbet
6、weenbeforeoperationandafteroperation.Therateofmisdiagnosiswas25.6%.Complicationsvariedfrom6caseswiththecutinfection,5caseswithlunginfection,6caseswithperitonealremainsinfection,3caseswithintestinalobstruction,!casewithmanurefistula,to1casewithperiton
7、ealsplit.ConclusionThroughinquiringaboutthehistoryofdiseaseingreatdetail,carefulmedicalcheck-up,makingproperuseofauxiliarydiagnosis,andcomprehensiveanalyses,treatmentdelayandmistreatmentmaybeavoided,andcomplicationsafteroperationwillbelesslikelytoocc
8、uetoo.Keywords:children'sacuteappendicitis;suppuration;perforation;diagnosis小儿急性阑尾炎是小儿腹部外科中最常见的疾病，它具有起病急，病情变化快，病势重，易坏疽穿孔，临床症状及体征不典型等特点。若对其估计不足以及处理不当，则可能发生较多并发症。我院2004-2010年收治小儿阑尾炎76例手术病人，其中有19例延误诊断，现将其诊治体会总结报道如下。1材料与方法1.1一般资料本组男30例，女13例；年龄1-13岁，其中1-5
