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ID:47887358
大小:53.05 KB
页数:7页
时间:2019-10-17
《小儿胆石症诊断与治疗体会(医学论文)》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、小儿胆石症诊断与治疗体会【摘要】目的探讨小儿胆石症的诊断与治疗方法。方法回顾性总结19年间小儿胆石症25例的临床资料。男19例,女6例;年龄5个月〜17岁(平均年龄9.5岁)。胆囊结石13例,胆总管结石9例,肝内胆管结石3例。合并急、慢性胆囊炎17例,其中胆囊积液、积脓5例;急性梗阻性化脓性胆管炎3例。除3例(胆囊结石1例和肝内胆管结石2例)经保守治疗症状缓解拒绝手术外,均行手术治疗。手术方式:胆囊切除10例,胆囊切开取石术2例;胆囊切除、胆总管切开取石术7例,单纯胆总管切开取石2例;肝管切开及肝左外叶切除1例。结果本组22例手术治愈出院,无并发症发生。17例(77.3%
2、)随访1〜10年,生长发育良好,仅1例偶有上腹部疼痛。E超检查未发现有残余结石及复发性结石者。结论小儿胆石症缺乏典型症状,对有腹痛和(或)黄疸者首选E超检查,结合腹部X线平片可提高诊断率;诊断确定应行手术治疗,胆囊切除是治疗胆囊结石较好术式,胆总管切开应严格掌握指征。【关键词】胆石症;儿童;诊断;治疗;胆囊切除术[Abstract]ObjectiveToinvestigatethediagnosisandtreatmentofcholelithiasisinchildhood.MethodsTheclinicaldataof25casesofcholelithiasisi
3、nchildhoodovera19-yearperiodwerereviewed.19casesweremaleand6casesfemale.Theagerangedfrom5monthsto17yearsold(theaverageageis9.6years).Therewere13casesofcholecystolithiasisand9casesofcholedocholethiasisand3casesofhepatolithiasis.17casessufferedfromacutechroniccholecystitisamongthose25casest
4、herewere5casesofhydrocholecystisorempyemaofgallbladderand3casesofacuteobstructivesuppurativecholang辻is.Except3cases(onewascholecystolithiasis,otherswerehepatolithiases)wererelievedthroughconservativetreatmentandrejectedoperation,goodresultswereachievedinalloperationcaseswithoutanycomplica
5、tions.10casesunderwentcholecystectomy,2casesreceivedcholecystolithotomy;cholecystectomyandcholedocholithotomywerecarriedoutin7cases,2casesreceivedcholedocholithotomy.Choledocholithotomyandleftexternalhepatectomywereperformedfor1case.ResultsFollow-upfor1to10yearsin17cases(77・3%)foundallchi
6、ldrengrewupwell,exceptonehadoccasionalpaininupperabdomen.NopatientsweredetectedwithrecurrentorresidualstonesthroughB-ultrasoundexamination.ConclusionTherewerenJttypicalclinicalsymptomsofcholecystolithiasisinchildhood・E・ultrasoundcanserveasachiefadjuvantdiagnosismethodinpatientswithabdomin
7、alpainandjaundice.WhenB-ultrasoundandX-raywereusedcombinedly,diagnosisrateandaccuracywereelevated.Surgicaltreatmentshouldbeappliedtocasesdiagnoseddeterminedly.Choiecystectomyisaneffectivemethodtotreatcholecystolethiasisandcholedochotomyshouldbecontrolledstrictlyinus
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