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1、小儿急性肠系膜淋巴结炎误诊为阑尾炎的临床研究于海洋张淑芳山东省威海临港区黄岚卫牛院264416摘要:目的:探讨并分析急性肠系膜淋巴结炎与急性阑尾炎患者的诊断结果,为制定减小误诊率的诊断措施提供参考依据。方法:选取我院20□年7月・2014年6月间收治的120例小儿肠系膜淋巴结和急性阑尾炎患儿,通过使用彩色多普勒超声诊断仪对所有患儿进行检查。对于诊断为肠系膜淋巴结的患儿采取抗炎症治疗,对于诊断为急性阑尾炎的患儿采取切除手术治疗。结果:在所选120例肠系膜淋巴结和急性阑尾炎患儿中,有25例急性阑尾炎患儿被误诊为急性肠系膜淋巴结,误诊
2、率为20.8%0肠系膜淋巴结患儿超声结果为淋巴结呈椭圆形,可见带状的流血信号,肠间隙有少量积液,经过抗炎治疗有好转。急性阑尾炎患儿超声结果有不同程度的肿胀现象,阑尾壁厚增加,阑尾腔变大,周围有积液,经过切除阑尾手术治疗后,病情好转。结论:对于有腹痛表现的患儿,应该怀疑是否患有肠系膜淋巴结炎的可能性,同时临床医师也应该不断学习,努力扩大知识面,也应该对查体给予足够的重视,密切观察患者的病情进展,并使自己的临床鉴别诊断能力提高,尽可能的避免误诊的发牛,使患者能够早日得到治愈。关键词:小儿急性肠系膜淋巴结;误诊;急性阑尾炎;临床研究[
3、Abstract]Objective:Toinvestigatethediagnosisandanalysisoftheresultsofpatientswithacutemesentericlymphadenitisandacuteappendicitis,providetherefereneetoreducethemisdiagnosisrateofdiagnosismeasures.Methods:120casesofchildrenwithpediatricmesentericlymphnodeselectsmycour
4、tyard2011July-2014yearinJunefromandacuteappendicitis,ofallpatientswereexaminedbyusingcolorDopplerultrasonicdiagnosticapparatus.Totakeanti-inflammatorytreatmentforthediagnosisofmesentericlymphnodesinchildren,forthediagnosisofacuteappendicitisinchildrenadoptedresection
5、operationtreatment.Results:intheselected120casesofmesentericlymphnodesandacuteappendicitisinchildren,25casesofchildrenwithacuteappendicitismisdiagnosedasacutemesentericlymphnodeStthemisdiagnosisrateis20.8%.Mesentericlymphnodesinchildrenwithultrasoundresultsforlymphno
6、dewasovabbloodsignalsvisibleribboruintestinalclearaneewithasmallamountofeffusion,afteranti-inflammatorytreatmentimproved.Childrenwithacuteappendicitisultrasoundresultshaveswellingtodifferentextent,appendicealwallthicknessisincreased,theappendixcavitybecomeslarge,effu
7、sionaround,afterappendectomyoperationafterthetreatment,theconditionimproved.Conclusion:forabdominalpaininchildrerushoulddoubtthepossibilitieswhetherpatientswithmesentericlymphadenitis,andcliniciansshouldalsocontinuetolearn,toexpandknowledge,shouldalsopayenoughattenti
8、ontocheckthebody,closeobservationofthepatient'sconditionandmakeprogress,improvetheclinicaldifferentialdiagnosisfromtheircapabilitie