临床小儿外科杂志2025，Vol.24Issue(2)：159-164,6.DOI:10.3760/cma.j.cn101785-202112055-010
免疫妥协儿童急性阑尾炎的临床特征及诊治探讨
Clinical features,diagnoses and treatments of acute appendicitis in immunocompromised children
陈巍 1刘璐 2刘婷婷 3王大勇 3张廷冲 2陈亚军2
作者信息
- 1. 国家儿童医学中心首都医科大学附属北京儿童医院普外科,北京 100045||北京清华长庚医院儿外科,北京 102218
- 2. 国家儿童医学中心首都医科大学附属北京儿童医院普外科,北京 100045
- 3. 国家儿童医学中心 首都医科大学附属北京儿童医院急诊外科,北京 100045
- 折叠
摘要
Abstract
Objective To explore the clinical characteristics and treatment of acute appendicitis in chil-dren with immune compromise.Methods From March 2007 to December 2020,the relevant clinical data were retrospectively reviewed for 29 immunocompromised children of acute appendicitis(AA)hospitalized at Affilia-ted Beijing Children's Hospital.Demographic profiles,clinical manifestations,laboratory tests and imaging find-ings were recorded.Results There were 21 boys and 8 girls with a male-to-female ratio of 2.63∶1.Median age was 4.4(3.05,8.45)year.Major symptoms included fever(n=24,82.8％)and abdominal pain(n=24,82.8％).And major physical signs included abdominal tenderness(n=23,79.3％),muscular rigidity(n=9,31.0％)and rebound tenderness(n=8,27.6％).Sixteen cases(n=16,55.2％)were accompanied by neutropenia(moderate,n=1;severe,n=15).All of them recieved multiple antibiotics.And 18 children(n=18,62.1％)were treated with one or more special restricted antibiotics.Ten children(n=10,34.5％)were operated upon an initial diagnosis of AA.Laparoscopy(n=7)and open surgery(n=3)were performed.Two laparotomic cases developed postoperative incision infection.And one laparoscopic case of intestinal obstruction at Month 2 post-operation was relieved after conservative measures.Nineteen children were treated conservative-ly.Except for 1 case giving up treatment due to multiple organ failure,18 children were clinically cured and dis-charged.Nine children underwent elective appendectomy during follow-ups and there were no perioperative com-plications.Conclusions For immunocompromised AA children,timely empirical co-dosing of broad-spectrum antibiotics is efficacious.If there are no absolute surgical contraindications,early surgery is both safe and effec-tive.关键词
急性阑尾炎/免疫妥协/病理状态,体征和症状/阑尾切除术/保守治疗/治疗结果/儿童Key words
Acute Appendicitis/Immunocompromised/Pathological Conditions,Signs and Symptoms/Appendectomy/Conservative Treatment/Treatment Outcome/Child引用本文复制引用
陈巍,刘璐,刘婷婷,王大勇,张廷冲,陈亚军..免疫妥协儿童急性阑尾炎的临床特征及诊治探讨[J].临床小儿外科杂志,2025,24(2):159-164,6.
