小儿急性阑尾炎伴中枢神经系统炎症单中心分析

Single Center Analysis of Acute Appendicitis with Central Nervous System Inflammation in Children

摘要: 目的：探讨急性阑尾炎伴中枢神经系统炎症的诊疗措施。方法：通过分析重庆医科大学附属儿童医院2012年6月至2023年3月诊断为急性阑尾炎伴中枢神经系统炎症的患儿以及对国内外相关文献的归纳总结。结果：10例患儿中，发病年龄范围为2小时~10岁，男女比例1:1。有7例出现腹痛症状，7例出现发热，5例出现呕吐，1例出现头痛，2例出现抽搐，4例出现神萎，2例出现烦躁不安，1例出现面瘫并跛行。其中4例为单纯性阑尾炎，1例为化脓性阑尾炎，5例为坏疽性阑尾炎。9例患儿预后良好，1例患儿出现中枢神经系统损害后遗症。结论：中枢神经系统炎症与阑尾炎严重程度并无明显关系，早期经验性使用抗生素能降低患儿的致残率及死亡率。

Abstract: Objective: To investigate the diagnosis and treatment of acute appendicitis with central nervous system inflammation. Methods: Children diagnosed with acute appendicitis with central nervous system inflammation in Children’s Hospital of Chongqing Medical University from June 2012 to March 2023 were analyzed and related literature at home and abroad was summarized. Results: In 10 cases, the age of onset ranged from 2 hours to 10 years old, and the ratio of male to female was 1:1. There were 7 cases of abdominal pain, 7 cases of fever, 5 cases of vomiting, 1 case of headache, 2 cases of convulsions, 4 cases of lethargy, 2 cases of restlessness, 1 case of facial paralysis and lameness. Among them, 4 cases were simple appendicitis, 1 case was suppurative appendicitis, and 5 cases were gangrenous appendicitis. The prognosis of 9 cases was good, and 1 case had sequelae of central nervous system damage. Conclusion: There is no significant relationship between central nervous system inflammation and the severity of appendicitis. Early empirical use of antibiotics can reduce the morbidity and mortality of children.