摘要
目的：探讨准确地诊断和治疗小儿假性胰腺囊肿．方法：总结近１０年来我们收治经Ｂ超、钡餐、ＣＴ和ＭＡＩ以及手术证实的假性胰腺囊肿１５例．结果：发现１５例中男１１例，女４例，年龄最小１岁４个月，最大１３岁，平均年龄９．４岁．而且７例有明显外伤史（７／１５，占４０％），恶心呕吐（１４／１５，占９３％）、腹痛（１１／１５，占７３％），腹部肿块（１０／１５，占６６％）为主要临床表现，其次有发热、消瘦、贫血．此外，在诊断上除依靠病史、体检和临床表现外，Ｂ超是最适宜和有价值的诊断依据，钡餐；ＣＴ和ＭＲＩ可以帮助诊断和鉴别诊断，还发现一旦血清淀粉酶下降后又重新回升，不但对确诊有重要意义，也是手术的重要指证。１４例接受手术治疗患儿均恢复良好，无１例死亡。结论：①小儿假性胰腺囊肿诊断除主要依靠病史、体征外，Ｂ超对小儿仍是有价值的辅助检查，诊断困难时可结合钡餐、ＣＴ和ＭＲＩ加以鉴别．②小儿假性胰腺囊肿多与外伤有关，男＞女，因男孩好动、顽皮受伤机率多．③囊肿形成超过６周，或者Ｂ超显示囊肿壁形成明显时应选用内引流手术，较大囊肿仅外引流难以治愈．
Objective: To investigate the diagnosis and management of pancreatic pseudocyst in children. Methods: 15 cases of pancreatic pseudocyst in children Who were diagnosed by ultrasound (US), barium meal (BM), computerized tomography (CT) and magnetic resonance image (MRI), were reviewed in the past ten years. Results: There were 11 boys and 4 girls of 15 cases ranging in age from 4 months to 13 years with mean age 9.4 years. Traumatic history (7/15), nausea and vomiting (14/15), abdominal pain (11/15) and abdominal mass (10/15) were main clinical presentations. The other appearances were fever, thin and anemia. The most appropriate and valuable diagnostic method was US besides history, signs and clinical presentations. BM, CT and MRI were valuable for diagnosis and differential diagnosis. Elevating amylase after return to normal range was the factor for confirming the diagnosis and was also the indication to operation. 14 cases that underwent operations recovered smoothly and no one died. Conclusions: (l) The diagnosis of pancreatic pseudocyst should depend on history and signs. The most valuable aid might be US, BM, CT and MRI could be important in differential diagnosis. (2) Most of pancreatic pseudocyst in children were associated with trauma. There were many boys because of their active and so as to have more incidences to be injured. (3) Indications for internal drainage were that pseudocyst had formed for more than 6 weeks or the cyst wall had formed apparently. It was difficult to cure large cyst with only external drainage.
出处
《伤残医学杂志》
2000年第3期18-20,共3页
Medical Journal of Trauma and Disability
关键词
假性胰腺囊肿
儿童
诊断
治疗
Pancreatic pseudocyst Children Diagnosis Management
