孩子哭鬧肚子疼 家長如何判斷嚴重程度

小兒外科急腹症是最常見而又很嚴重的一組疾病,包括小兒闌尾炎、腸套疊、嵌頓疝等。其臨床表現多為腹痛、嘔吐、腹瀉、便秘和便血,甚而出現休克,如不能及時做出正確的診斷及後續治療,將造成嚴重的後果甚至危及患兒生命。南京市兒童醫院普外科副主任醫師黃磊說,“一兩歲的闌尾炎患兒,一般8到12個小時之後就會出現穿孔,然後引發腹膜炎、休克,甚至有生命危險,所以家長還是應及早重視起來!”

如何判定小兒患上了急腹症,黃磊稱,這裏面有一定的困難。比如小兒闌尾炎,通常不會像成人那樣有比較明顯的轉移性右下腹疼痛、壓痛和反跳痛表現,如果對象是年齡較小的孩子,他講不清楚,表達不舒服最常用的手段是哭鬧。那麼家長該如何及早發現急腹症所致的腹痛呢?

小兒闌尾炎所致的腹痛通常呈進行性加重,症狀多有腹痛及嘔吐,“如果一直哭鬧,不吃不喝,一吃就吐,需要引起重視,”黃磊表示。另外,小兒闌尾炎多數還伴有發熱,孩子精神狀態不好。通常外科醫生通過查體、血常規及腹部超聲檢查可作出診斷。一旦確診為闌尾炎時,最好是選擇盡快手術治療。

另外,腸套疊這種情況常見於2歲內的小兒,尤其是4到10個月內的小兒多見。腸套疊所致的肚子疼常表現為突然的陣發性的腹痛哭鬧,家長會說“我小孩幾點前都是很好的,之後就一陣一陣哭鬧不安,怎麼樣都哄不住”,陣發性的原因主要跟腸子蠕動的特點有關,當蠕動波到達套疊部位的時候,疼痛才會發生,所以,腸套疊發生的時候,玩得正起勁的寶寶會突然哭得很厲害,持續一會後,孩子又像平時一樣玩耍了,間隔一段時間後,腹痛又開始了,如此反複發作。

說到小兒外科手術,很多家長都覺得是一個需要開腹的大手術,隨著近些年醫療技術水平的提高,每年在南京市兒童醫院做微創手術治療急腹症的患兒在2000例左右,其中小兒闌尾炎的手術治療上微創用得最多,目前90%的該類患兒都是經微創手術治療的。

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S.Korea’s direct overseas urchases jum in H1

Direct overseas urchases by South Koreans through online channels rose in the first half on strong demand for Chinese roducts, customs office data showed on Friday.

Direct urchases of foreign goods totaled $1.32 billion, u 35 ercent year-on-year, according to the Korea Customs Service.

The growth rate was about three times faster than the total rise in imorts, which was 13 ercent.

Direct urchases of Chinese roducts exanded. The number of Chinese electronics roducts urchased 882,000, comared with 880,000 a year earlier.

The best-selling roduct category was US health foods, rising 33 ercent to $2.6 million.

China’s market share was 23 ercent in the first half, u from 17 ercent a year earlier, while the US share fell from 56 ercent to 53 ercent.

South Koreans in their 30s were the biggest direct buyers of overseas roducts, accounting for 47 ercent of the total, followed by those in their 40s with 24 ercent and those in their 20s with 20 ercent.

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