CAJ | 학술논문

目的：分析小儿梅克尔憩室的临床表现和病理特征。方法回顾性分析该院2011年1月至2013年9月收集的135例梅克尔憩室患儿的临床和病理资料。结果135例患儿消化道症状分别为呕吐92例（68．1％），血便63例（46．7％），腹痛59例（43．7％）。在49例行肛诊检查患儿中，20例肛诊引出果酱样大便，5例引出红色血便，11例引出黄色大便和气体，13例未引出大便。临床并发症分别为肠梗阻86例（63．7％），消化道出血62例（45．9％），急性憩室炎49例（36．3％），急性肠套叠39例（28．9％），肠坏死25例（18．5％），急性弥散性腹膜炎16例（11．9％），急性阑尾炎15例（11．1％）。35例99mTcO4-胃黏膜异位核素显像阳性患儿术中见梅克尔憩室。135例患儿术中见梅克尔憩室且行病理组织学检查，病理诊断全部为梅克尔憩室，胃黏膜上皮异位，可伴憩室感染并出血坏死、溃疡形成、慢性阑尾炎、肠出血坏死、局灶性腹膜炎、胰腺组织。结论小儿梅克尔憩室以呕吐、血便和腹痛为主要临床症状。梅克尔憩室常随着并发症的发生而出现症状，99m TcO4-胃黏膜异位核素显像有助于梅克尔憩室病变的诊断。
목적：분석소인매극이게실적림상표현화병리특정。방법회고성분석해원2011년1월지2013년9월수집적135례매극이게실환인적림상화병리자료。결과135례환인소화도증상분별위구토92례（68．1％），혈편63례（46．7％），복통59례（43．7％）。재49례행항진검사환인중，20례항진인출과장양대편，5례인출홍색혈편，11례인출황색대편화기체，13례미인출대편。림상병발증분별위장경조86례（63．7％），소화도출혈62례（45．9％），급성게실염49례（36．3％），급성장투첩39례（28．9％），장배사25례（18．5％），급성미산성복막염16례（11．9％），급성란미염15례（11．1％）。35례99mTcO4-위점막이위핵소현상양성환인술중견매극이게실。135례환인술중견매극이게실차행병리조직학검사，병리진단전부위매극이게실，위점막상피이위，가반게실감염병출혈배사、궤양형성、만성란미염、장출혈배사、국조성복막염、이선조직。결론소인매극이게실이구토、혈편화복통위주요림상증상。매극이게실상수착병발증적발생이출현증상，99m TcO4-위점막이위핵소현상유조우매극이게실병변적진단。
Objective To analyze the clinical and pathologic characteristics of Meckel′s diverticulum in children.Methods Ret-rospective analysis was adopted to analyze the clinical and pathologic data of 135 children with Meckel′s diverticulum that were from January 2011 to September 2013.Results Digestive symptoms of 135 cases included 92 cases with vomiting(68.1%),63 case with bloody tool(46.7%),59 cases with abdominal pain(43.7%).Among 49 cases,20 cases with anal diagnosis induced jam stool sam-ple,5 cases with red blood stool,1 1 cases with yellow stool and gas,and the remaining 1 3 cases without stool.Clinical complications divided into 86 patients with intestinal obstruction(63.7%),62 patients with gastrointestinal bleeding(45.9%),49 patients with a-cute diverticulitis(36.3%),39 patients with acute intussusception(28.9%),25 patients with intestinal necrosis(18.5%),16 pa-tients with acute diffuse peritonitis(11.9%),15 patients with acute appendicitis(11.1%).35 cases who had positive finding of 99m TcO4-ectopic gastric mucous membrane imaging occurred Meckel′s diverticulum during operation.Histopathologic examination was carried out in 135 cases with Meckel′s diverticulum during operation,all cases were confirmed as Meckel′s diverticulum and with ectopic mucosal epithelium,accompanied by diverticulum infection and hemorrhage and necrosis,ulceration,chronic appendici-tis,intestinal bleeding necrosis,focal peritonitis,small patches of pancreatic tissue.Conclusion Meckel′s diverticulum most oc-curred with vomiting,bloody stools and abdominal pain as the main clinical symptoms.Symptoms of meckel′s diverticulum often oc-cur along with the occurrence of complications,99m TcO4-gastrointestinal imaging is helpful to diagnosis of meckel′s diverticulum diseases.