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目的分析小儿急性肠系膜淋巴结炎的临床特征,探讨其发病机制、诊断要点及鉴别诊断。方法对本院2009～2010年收治的36例小儿急性肠系膜淋巴结炎患儿的临床症状、体征、实验室资料及腹部B超检查进行分析。结果 36例患儿中男25例(69.44%),女11例(30.56%),男孩多于女孩;发病年龄以3～7岁为主,为26例(72.22%),其次为1～3岁,为6例(16.67%),7-12岁为4例(11.11%);所有患儿均有腹痛表现,伴有腹肌紧张仅1例(2.78%),均无反跳痛;22例(61.11%)有发热表现;伴有呼吸道症状如咳嗽20例(55.56%),咽痛22例(61.11%);伴有呕吐14例(38.89%),腹泻5例(13.89%);血常规白细胞总数大于10×109/L者26例(72.22%);腹部B超显示所有病例均有不同程度的肠系膜淋巴结肿大,大小为76mm～207mm。结论小儿急性肠系膜淋巴结炎的诊断可结合患儿有上呼吸道感染或肠道感染的前驱病史;腹部压痛不固定;腹部B超提示多发肠系膜淋巴结肿大;并排除其他引起腹痛的常见病后即可诊断。
Objective To analyze the clinical features of children with acute mesenteric lymphadenitis and to explore its pathogenesis, diagnosis points and differential diagnosis. Methods The clinical symptoms, signs, laboratory data and abdominal ultrasonography of 36 children with acute mesenteric lymphadenitis treated in our hospital from 2009 to 2010 were analyzed. Results There were 25 males (69.44%) and 11 females (30.56%) in 36 cases, more boys than girls. The age of onset was 3-7 years old, accounting for 26.2% (72.22%), followed by 1-3 6 cases (16.67%) were old, 4 cases (11.11%) were aged 7-12 years old. All children had abdominal pain, only one case (2.78%) had abdominal muscle tension without rebound pain. 20 cases (55.56%) had respiratory symptoms such as cough, 22 cases (61.11%) had sore throat, 14 cases (38.89%) had vomiting, 5 cases (13.89%) had diarrhea, blood 26 cases (72.22%) had conventional leukocytes more than 10 × 109 / L; abdominal ultrasonography showed that all the cases had different degrees of mesenteric lymph nodes with the size of 76mm ~ 207mm. Conclusions The diagnosis of acute mesenteric lymphadenitis in children can be combined with the history of children with upper respiratory tract infection or intestinal infection; abdominal tenderness is not fixed; abdominal B-medulloblast mesenteric lymph nodes, and rule out other common causes of abdominal pain can be diagnosis.