CAJ | 학술논문

目的：探讨小儿外伤性小肠穿孔的早期诊断及手术方式，以提高诊治水平。方法回顾性分析20例外伤性小肠穿孔患儿的临床资料，包括临床症状、辅助检查、手术方式及诊治结果。结果患儿均有不同程度腹痛及腹膜炎体征，10例腹腔穿刺中，阳性8例（80％）；10例腹部立位片检查中，5例见膈下游离气体（50％）；17例B超检查中，10例有显著腹腔积液（58．8％）；12例CT检查中，9例有异常（75％），均经手术治愈出院，其中3例出院后1月余出现粘连性肠梗阻，予保守治疗后痊愈出院，1例因乙状结肠造瘘术后再次入院行造瘘口回纳术，术后痊愈出院。结论小儿外伤性小肠穿孔多有腹痛、腹膜炎等临床特点，结合辅助检查有利于早期诊断，选择合适的手术方式是提高治愈率的关键。
목적：탐토소인외상성소장천공적조기진단급수술방식，이제고진치수평。방법회고성분석20예외상성소장천공환인적림상자료，포괄림상증상、보조검사、수술방식급진치결과。결과환인균유불동정도복통급복막염체정，10례복강천자중，양성8례（80％）；10례복부립위편검사중，5례견격하유리기체（50％）；17례B초검사중，10례유현저복강적액（58．8％）；12례CT검사중，9례유이상（75％），균경수술치유출원，기중3례출원후1월여출현점련성장경조，여보수치료후전유출원，1례인을상결장조루술후재차입원행조루구회납술，술후전유출원。결론소인외상성소장천공다유복통、복막염등림상특점，결합보조검사유리우조기진단，선택합괄적수술방식시제고치유솔적관건。
Objetive To explore the early diagnosis and treatment of traumatic small intestinal perfora-tion in children in order to improve the level of diagnosis and treatment. Methods Retrospective analysis was given to the clinical data(clinical symptoms,auxiliary examination,surgical procedures and the results)in 20 children with traumatic small intestinal perforation. Results All the children had different degrees of abdomi-nal pain and positive peritoneal irritation sign,there were 8 positive cases among 1 0 cases undergoing abdominal puncture,accounting for 80%,5 cases showed subdiaphragmatic free air in 1 0 cases undergoing X-ray examina-tion,1 0 cases showed marked ascites in 1 7 cases undergoing B-ultrasonography,9 cases showed abnormal in 1 2 cases undergoing CT examination.All were cured by surgical operation,three cases showed adhesive intestinal obstruction after discharging about one month were cured after conservative treatment.One case came back to have colostomy reversal surgery for postoperation of sigmoid colostomy. Conclusion Most of children with traumatic small intestinal perforation have clinical characteristics such as abdominal pain,peritonitis,etc.Com-bined with the auxiliary examination,it is helpful for the early diagnosis.Select the appropriate operation method is the key to improve the cure rate.