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目的探讨小儿慢性阑尾炎的临床特点。方法回顾分析我院2010年12月~2013年12月收治并通过手术及病理确诊137例小儿慢性阑尾炎患儿的临床资料。结果 A组14例,为反复发作、右下腹疼痛病史≥1个月的患儿,各年龄段散发,6~14岁较3~5岁年龄段儿童发生率显著增加,差异有统计学意义(P<0.01);B组74例,为阑尾周围脓肿治愈后的患儿,好发年龄为3~5岁,与6~14岁年龄段比较,差异有统计学意义(P<0.01);C组49例,为未能描述典型急、慢性阑尾炎病史的患儿,好发年龄集中在4~8岁,但6~14岁较3~5岁年龄段儿童发生率显著增加,差异有统计学意义(P<0.01)。C组行胃肠钡餐或钡剂灌肠检查:59.18%(29/49)的患儿有程度不等的充盈缺损,24小时复查腹部立位片,80.49%(33/41)的患儿可见阑尾腔钡剂残留。所有患儿均行手术及病理确诊慢性阑尾炎,治愈出院,随访1个月~3年,未见并发症。结论小儿慢性阑尾炎不容易诊断,好发年龄为3~5岁,学龄前儿童常见,确诊后应行手术治疗。部分患者未能描述典型急、慢性阑尾炎病史的患儿,进行胃肠钡餐或钡剂灌肠检查(包括24h复查)有很高的参考价值。
Objective To investigate the clinical features of children with chronic appendicitis. Methods The clinical data of 137 children with chronic appendicitis diagnosed in our hospital from December 2010 to December 2013 by surgery and pathology were retrospectively analyzed. Results A group of 14 patients with recurrent and right lower quadrant pain history ≥ 1 month, children of all ages, 6 to 14 years old compared with 3 to 5 years old children increased significantly, the difference was statistically significant ( P <0.01). In group B, 74 cases were cured after abscess of appendix. The prevalence was 3 to 5 years old. There was significant difference between the age group of 6-14 years old (P <0.01); C The group of 49 cases failed to describe the history of typical acute and chronic appendicitis in children with good onset concentrated in the 4 to 8 years old, but 6 to 14 years old children aged 3 to 5 significantly increased the incidence, the difference was statistically significant Significance (P <0.01). In group C, the patients underwent gastrointestinal barium meal or barium enema examination: 59.18% (29/49) children had varying degrees of filling defect. The abdominal orthopedic tablets were reviewed 24 hours later, and the appendix was found in 80.49% (33/41) Cavity barium residue. All children underwent surgery and pathological diagnosis of chronic appendicitis, cured and discharged, followed up for 1 month to 3 years, no complications. Conclusion Chronic appendicitis is not easy to diagnose in children. The incidence is very high in 3 ~ 5 years old. Preschoolers are common and should be treated surgically after diagnosis. Some patients failed to describe the history of typical acute and chronic appendicitis in children with gastrointestinal barium meal or barium enema examination (including 24h review) have a high reference value.