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目的总结小儿梅克尔憩室的诊断及治疗经验。方法回顾性分析38例小儿梅克尔憩室患者的临床资料。结果 38例患儿中,有无痛性便血3例,反复肠套叠发作4例,反复脐部感染1例;6例以“急性肠套叠”入院,空气灌肠失败,急诊手术,术中发现梅克尔憩室为肠套叠起套点;10例患儿因梅克尔憩室致“急性肠梗阻”入院;梅克尔憩室炎2例;梅克尔憩室穿孔2例;梅克尔憩室瘘致反复腹壁感染1例;无症状的梅克尔憩室9例。所有病例行梅克尔憩室切除,肠吻合;术后恢复良好,痊愈出院;随访1个月~5年,无二次手术及相关并发症发生。结论梅克尔憩室可引起多种并发症。对怀疑梅克尔憩室的患儿,~(99 )Tc~m同位素扫描等检查在术前可做出较明确诊断。手术需要尽量行肠切除肠吻合,以防残留异位组织。腹部手术术中应常规探查有无梅克尔憩室,对于无症状的梅克尔憩室,也建议实施手术切除。
Objective To summarize the diagnosis and treatment experience of Meckel’s diverticulum in children. Methods The clinical data of 38 children with Meckel’s diverticulum were retrospectively analyzed. Results 38 cases of children with painless blood in the stool in 3 cases, repeated intussusception in 4 cases, repeated umbilical infection in 1 case; 6 cases with “acute intussusception” admission, air enema failure, emergency surgery, Meckel diverticulum was found in the intussusception; 10 cases of children due to Merkel diverticula caused by “acute intestinal obstruction” admission; Meckel’s diverticulitis in 2 cases; Merkel diverticulum perforation in 2 cases; Meckel diverticulum fistula induced repeated abdominal infection in 1 case; asymptomatic Merkel diverticulum in 9 cases. Meckel diverticulum excision and bowel anastomosis were performed in all the cases. After the operation, the patients recovered well and were discharged. The patients were followed up for 1 month to 5 years without secondary surgery and related complications. Conclusion Merkel diverticulum can cause a variety of complications. For suspected Merkel diverticulum in children, ~ (99) Tc ~ m isotope scan and other tests can make a more definite diagnosis before surgery. Surgical operation of intestinal resection should try to intestinal anastomosis to prevent residual ectopic tissue. Abdominal surgery should be routinely explored with or without Merkel diverticulitis, Merck’s diverticulum asymptomatic, but also recommended the implementation of surgical resection.