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目的 总结儿童阑尾炎临床诊断与治疗12年来的进展。方法 回顾性分析1991年1月至2 0 0 2年12月收治的2 390例儿童阑尾炎的临床病理资料。结果 本组中单纯型2 37例(9 .91% ) ;化脓型1798例(75 .2 3% ) ,合并穿孔5 6 8例(31.5 9% ) ;坏疽型2 12例(8 .81% ) ,合并穿孔15 9例(71 .36 % ) ;梗阻型14 1例(5 .89% ) ;阑尾脓肿192例(7 .4 % ) ,其中手术切除阑尾加脓肿引流2 0例(0. 83% )。本组平均穿孔率为30 . 12 % ,1岁以下17例(41 .4 6 % ) ,1～4岁2 0 1例(44 .96 % ) ,5～10岁4 0 4例(2 8. 17% ) ,10岁以上98例(2 0. 94 % )。本组患者全部治愈出院。结论 单纯型阑尾炎手术比例数与穿孔率呈反比关系,反映手术指征宽严度与诊疗水平的情况。儿童阑尾炎的穿孔率在30 %左右是可以接受的。
Objective To summarize the progress of clinical diagnosis and treatment of appendicitis in children over the past 12 years. Methods The clinical and pathological data of 2 390 children with appendicitis admitted from January 1991 to December 2002 were analyzed retrospectively. Results There were 2 37 simple cases (9.91%), 1798 cases (75.23%) with perforation, 568 cases (31.5%) with perforation, 12 cases (8.281% ), 15 cases (71.36%) had perforation, 14 cases (5.89%) had obstruction, 192 cases (7.4%) had appendectomy, 20 cases had appendectomy and abscess drainage. 83%). The average perforation rate was 30.12% in this group, 17 cases (41.46%) under 1 year old, 201 cases (44.96%) 1-4 years old and 404 cases (28% 17%), 98 cases over the age of 10 (2.094%). All patients in this group were cured. Conclusions The proportion of simple appendicitis surgery is inversely proportional to the rate of perforation, reflecting the wide range of surgical indications and the level of diagnosis and treatment. Children’s appendicitis perforation rate of about 30% is acceptable.