儿童尾炎:年龄真的重要吗?
Kamal El Haissoufi1,2, El Hassan Hadi1,2, Salaheddine Habib1,2
1Department of Visceral and Urological Pediatric Surgery "A", Mohammed VI University Hospital, Oujda, Morocco.
African journal of paediatric surgery : AJPS
|September 24, 2024
概括
幼儿急性尾炎往往呈非典型,学龄前儿童出现更严重的症状和更高的穿孔率. 在这个年龄组中早期诊断尾炎仍然具有挑战性.
科学领域:
- 儿科手术 儿科手术
- 紧急医疗 紧急医疗
- 临床诊断 临床诊断 临床诊断
背景情况:
- 急性尾炎 (AA) 是儿童常见的手术紧急情况.
- 在年轻的儿科患者群体中,AA存在独特的诊断挑战.
- 了解AA呈现的年龄相关差异对于及时干预至关重要.
研究的目的:
- 为了比较临床表现,诊断分数和学龄儿童与学龄儿童急性尾炎的结果.
- 确定导致AA年轻儿童诊断挑战的因素.
- 评估诊断分数 (PAS和Alvarado) 在不同年龄组区分尾炎严重程度的有用性.
主要方法:
- 对402名儿科患者 (16岁以下) 进行了回顾性审查,确认了AA.
- 分为两组:A组 (学龄前儿童,年龄 ≤5岁) 和B组 (学龄儿童,年龄 >5岁).
- 对临床症状,生物标志物,诊断分数 (儿科尾炎分数 [PAS],阿尔瓦拉多分数) 和手术内发现的比较分析.
主要成果:
- 学前儿童 (A组) 发烧,肠道疾病,扩散性腹痛和疼痛 (P < 0.001) 的比率较高.
- 组A显示白细胞计数和C反应蛋白水平显著增加 (P < 0.003).
- 在A组中观察到更高的平均PAS和Alvarado得分,其中更大比例的得分≥8 (P < 0.001),并且尾孔穿孔率显著更高 (77.3%对41.5%,P < 0.0001).
结论:
- 学前儿童的急性尾炎的特点是异常表现和疾病的快速进展.
- 在学龄前儿童中早期诊断AA是更具挑战性的.
- 这些发现强调了需要加大临床怀疑和可能修改的诊断方法在非常年幼的儿童中AA.
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