超声引导内镜下逆行阑尾炎治疗术在阑尾相关慢性腹痛患儿中的应用价值

Application of ultrasound-guided endoscopic retrograde appendicitis therapy in children with appendix-related chronic abdominal pain

摘要:

目的 探讨超声引导内镜下逆行阑尾炎治疗术在儿童阑尾相关慢性腹痛中的临床疗效。 方法 回顾性收集2019年8月至2021年5月收治的以慢性腹痛为主诉，超声提示阑尾炎症或腔内粪便或粪石且行超声引导内镜下逆行阑尾炎治疗术患儿30例的临床资料，分析其临床表现、内镜下表现、白细胞计数及中性粒细胞百分比、住院时间、治愈率。 结果 30例慢性腹痛患儿中，男童13例（43%），女童17例（57%），平均确诊年龄（9±3）岁，年龄范围3~15岁，中位病程持续时间12个月，中位住院时间3 d；中位白细胞计数6.7×10⁹/L，中性粒细胞百分比为（50±13）%。21例（70%）术中阑尾腔内冲洗出粪石及大量粪渣。随访率97%（29/30），中位随访时间11（范围：5~26）个月，27例（93%）腹痛症状完全消失。 结论 超声引导内镜下逆行阑尾炎治疗术对阑尾腔内粪便或粪石引起的儿童慢性腹痛治疗有效。

Abstract:

Objective To study the clinical efficacy of ultrasound-guided endoscopic retrograde appendicitis therapy in children with appendix-related chronic abdominal pain. Methods A retrospective analysis was performed on the medical data of 30 children with the chief complaint of chronic abdominal pain who were admitted from August 2019 to May 2021. All the children were found to have inflammation of the appendix or intracavitary stool and fecalith by ultrasound and underwent ultrasound-guided endoscopic retrograde appendicitis therapy. The medical data for analysis included clinical manifestations, endoscopic findings, white blood cell count, neutrophil percentage, length of hospital stay, and cure rate. Results Among the 30 children with chronic abdominal pain, there were 13 boys (43%) and 17 girls (57%), with a mean age of (9±3) years (range 3-15 years) at diagnosis. The median duration of the disease was 12 months, and the median length of hospital stay was 3 days. The children had a median white blood cell count of 6.7×109/L and a neutrophil percentage of 50%±13%. Fecalith and a large amount of feces were flushed out of the appendix cavity for 21 children (70%) during surgery. The follow-up rate was 97% (29/30), and the median follow-up time was 11 months (range 5-26 months). Of the 29 children, abdominal pain completely disappeared in 27 children (93%). Conclusions Ultrasound-guided endoscopic retrograde appendicitis therapy is effective in children with chronic abdominal pain caused by feces or fecalith in the appendix cavity.