小兒急性腹部症之臨床觀察

Clinical Observation of Acute Abdomen in Pediatric Field

呂志忠(Chu-Chong Lu)

《Acta Paediatrica Sinica》 9卷3期 (1968/09) Pp. 137-145

摘要

在高雄醫學院過去9年半間住院治療之急性腹部症236例，分析觀察得如下之結果：
新生兒期最常見之急性腹部症為胃腸穿孔，而乳兒期之最常見之急性腹部症為腸套壘佔腸阻塞之57.3%。腸套壘病例男比女多，年齡最小者為生下3個月，4到9個月佔大多數，發生最多在冬季，以月別是1月最多，其次為12月。大多數病例皆無熱或微熱，90.5%之病例末梢白血球數超過10.000/(立方公厘)。除4例用高壓灌腸治療外，其餘75例皆接受外科開刀治療法，全部死亡率為7.6%。
年齡愈大愈常見之急性腹部症為急性蟲垂炎及穿孔。急性蟲垂炎比穿孔病例，易發生在較年輕者，且男比女多，又前者比後者較早期住院。急性蟲垂穿孔病例之體溫及末梢白血球數均比單純性蟲垂炎較高。

並列摘要

During the past nine and half years, 236 cases of acute abdomen in infancy and childhood were admitted in Kaohsiung Medical College Hospital, and the clinical observations were summarized as follows:
The most common cause of acute abdomen in neonatal period was G-I perforation, and in infancy was intussusception which occupied 57.3% of intestinal obstruction. There was a sex predominance of male in intussusception and the youngest patient was three month old, however, more than half of the patients were from 4 to 9 months. Intussuception occurred most frequently in winter, especially in January and in December. No fever was found in the most cases of intussusception and 90.5% of these cases had leukocytosis over 10,000/mm^3. All cases of intussuception were received surgical treatment, except 4 cases were treated with barium enema. The total mortality was 7.6%.
The most common disease of the acute abdomen in the older children was acute appendicitis and its perforation. Appendical perforation attacked more frequently in the younger age group than acute appendicidis only, and male was more prominent than female. The interval from the onset till hospitalization in acute appendicitis was shorter than that in appendical perforation. The body temperature and white blood cell count of the cases with appendical perforation were higher than that of the cases with acute appendicitis only.