潘建伟

【摘 要】急性非特异性肠系膜淋巴结炎是儿童腹痛的常见原因之一。发病前常有上呼吸道感染病史，典型临床表现为发热、脐周或右下腹痛，查体脐周及右下腹压痛，程度较轻。超声检查提示至少3个及以上肠系膜淋巴结增大，且短轴≥5mm或≥8mm，排除其他引起腹痛的原因。治疗以对症、补液、心理支持为主，益生菌及中西医结合治疗亦有报道。本病为自限性疾病，预后大多良好，但相关研究报道并不多，本文拟对该疾病诊治做一综述以便更好了解重视。

【关键词】小儿；急性非特异性肠系膜淋巴结炎；腹痛

中图分类号： R572.3；R657.2 文献标识码： A 文章编号： 2095-2457（2018）24-0181-002

DOI：10.19694/j.cnki.issn2095-2457.2018.24.088

【Abstract】Acute Nonspecific Mesenteric Lymphadenitis is one of the common causes of abdominal pain in children.There is often a history of upper respiratory infection， clinical symptoms of fever， abdominal pain， physical examination founds umbilical and right lower mild abdominal tenderness. Ultrasonography showed that at least 3 or more mesenteric lymph nodes were enlarged， and the shorter axis was ≥5mm or≥8mm， excluding other causes of abdominal pain. Symptomatic treatment， fluid infusion， psychological support， probiotics and integrated Chinese and western medicine also reported. This disease is a self-limited disease with a good prognosis， but there are not many related studies reported. This paper intends to make a review of the diagnosis and treatment of this disease for better understanding and attention.

【Key words】Children；Acute nonspecific mesenteric lymphadenitis；Abdominal pain

急性非特异性肠系膜淋巴结炎（Acute Nonspecific Mesenteric Lymphadenitis，下文简称肠系膜淋巴结炎）是一种影响肠系膜淋巴结的自限性炎症疾病[1]，多见于儿童，临床表现缺乏特异性。1921年Brennemann首先报道本病，因此也称Brennemann综合征，是疑似阑尾炎或肠套叠患儿最常见的替代诊断[2-3]。近年由于高质量影像学检查的普及应用和医务工作者对本病认识的提高，发病呈逐年增多趋势，但关于肠系膜淋巴结炎的研究并不多[4]，它的疾病特点、诊治进展等仍有许多尚未阐明。本文拟对小儿急性非特异性肠系膜淋巴结炎的诊治做一综述。

1 诊断

目前国内外尚无统一的小儿肠系膜淋巴结炎的诊断标准，临床上诊断本病主要依靠病史、临床表现及多普勒超声检查。国外最新文献报道有以下情况可考虑急性非特异性肠系膜淋巴结炎诊断[5]：（1）急性阵发性腹痛，多位于脐周及右下腹；……