X线透视下空气灌肠辅以腹外按压诊治小儿急性肠套叠(附158例分析)  

The Diagnose and Therapy of Acute Infants Intussusception by Air Enema Aid Abdomen Press under X-ray(analysis 158 cases)

作　　者：刘文义 

机构地区：[1]呼伦贝尔市人民医院放射科,内蒙古呼伦贝尔021008

出　　处：《黑龙江医学》2007年第1期21-23,共3页Heilongjiang Medical Journal

摘　　要：目的提高对空气灌肠适应证辅以腹外按压病例的选择、操作要点、小儿急性肠套叠的诊断,及其临床价值的认识。方法分别摄取常规腹部平片、空气灌肠配合腹部手法按压诊断与整复、灌肠后腹部立位透视,整复失败者行外科剖腹探查,对空气灌肠配合腹外按压的指证、操作要点及统计结果回顾分析。结果①腹平片:未出现典型肠梗阻表现146例,出现典型肠梗阻表现12例;②在诊断气压下空气灌肠出现X线征象:杯口状软组织块影145例,无软组织块影13例,杯口状影合并钳状影、球状块影、息肉状影、分叶状影分别281、74、8、例;③气压整复成功145例,软组织块影由大变小直至消失,未成功13例,软组织块影逆行前移不明显或前移一段距离后再无变化。整复未成功者,外科剖腹探查伴肠坏死9例、肠套叠过深2例、复合肠套叠2例。结论小儿急性肠套叠,在适应证范围之内,空气灌肠辅以腹外手法按压具有肯定的诊断与治疗价值,应首选这一方法。Objective To improve the recognition of air enema aid abodomen press in diagnose and therapy of acute intussusception in infants.Methods Step by step shooting abodominal plain radiograph, air enema aid abodomen press, abodomen erect position perspective after enema, surgery exp. Lap. ff restitution failed. To retrospective analysis the indication, operation key points and statistical results of air enema aid abdomen press. Results （1）Abodominal Plain radiograph： 146 cases didn＇t have the appearance of typical intestinal obstruction, and another 12 cases did. （2）X- ray signs displayed in diagnostic air pressure of air enema： 145 cases displayed cupping soft tissue shadow, 13 cases none. 28, 17, 4, 8 cases displayed Cupping shadow complicated with clamp, polypus or sublobe shadow respectively. （3）145 cases restitution successfully, the soft tissue shadow shrinked, even vanished. 13 cases unsuccessfully, which shadow didn＇ t change obviously. There are 9 cases complicate with bowels necrosis, 2 cases deep intussusception, 2 cases complexed intussusception. Conclusion If in indications, air enema aid abdomen press is the frost choice for the diagnose and treatment of acute intussusception in infants.

关 键 词：空气灌肠 腹外按压 肠套叠 

分 类 号：R574.3[医药卫生—消化系统]