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小儿腹部肿大淋巴结分析

     

摘要

To compare the enlarged mesenteric lymph nodes in healthy children with those children with mensenteric lymphadenitis. Methods According to the diagnostic criteria defining lymph node enlargement as a 5-mm enlargement or greater in the short diameter, 137 healthy children and 148 children with mensenteric lymphadenitis were retrospectively analyzed for mesenteric lymph node enlargement based on the ultrasonographic data. Results The distribution of enlarged mesenteric lymph nodes was detected in the right lower quadrant (RLQ) in 46.3%, in the para-aortic areas in 19.2%, and in the left lower quadrant (LLQ) in 13.6% of the children. The clusters of lymph nodes between the two groups showed no significant difference in the distribution, age, L/W, longitudinal diameter or clusters, only the short diameter differed significantly between them. Conclusion Enlarged mesenteric lymph nodes are present in many healthy children, which does not necessarily suggests any abnormalities. The mesenteric lymph nodes increase with the age until 6 years and then decrease. The lymph nodes with a short diameter larger than 8 mm may indicate the condition of mesenteric lymphadenitis.%目的 比较健康儿童与肠系膜淋巴结炎患儿腹腔肿大淋巴结的差异情况.方法 以淋巴结短径>0.5 cm作为淋巴结肿大的诊断标准,对健康儿童137例及148例临床诊断为肠系膜淋巴结炎患儿腹腔肿大淋巴结行同顾性研究,并进行统计学分析.结果 淋巴结多位于右下腹和脐周(46.3%位于右下腹,19.2%位于脐周,13.6%位于左下腹).3个以上成簇的淋巴结健康儿童53%(72/137),淋巴结炎患儿47%(69/148),无差异(P=0.3771) 两组间肿大的淋巴结在各个年龄段及性别间没有统计学差异,长径及长径/短径均没有统计学差异,仅两组间短径有统计学差异.结论 很多健康儿童存在腹腔肿大的成簇的淋巴结,所以不能主观认为这些淋巴结的存在就是异常现象.6岁儿童腹腔肿大淋巴结出现达到高峰,然后随着年龄的增长逐渐减少.短径超过0.8 cm的腹腔淋巴结也许能够直接提示肠系膜淋巴结炎的诊断.

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