气蜡灌肠对小儿肠套叠的复位作用  

The effect of air-max enema on children with intussusceptions

作　　者：李玲 王官清 王浩 董继伟 郭俊杰 黄兰香 

机构地区：[1]武汉市新洲区人民医院,431400

出　　处：《中国实用医药》2008年第34期27-28,共2页China Practical Medicine

基　　金：武汉市科技局2005-2007已批准科研项目

摘　　要：目的提高小儿肠套叠灌肠复位率,避免肠穿孔意外发生。方法术前一律肌肉注射654-2,在无麻醉下取头低足高俯卧位插入Fuler’s肛管,灌肠器内放入10--20 ml液体石蜡,术者手握带压力表的加压气球,保持低压（80 mm Hg内）,慢速注气,透视观察套头部的运动变化,以套头部退出回盲部软组织块影消失,小肠进入气体为复位标准。术后禁食24 h以静脉营养,抗感染、止血、解痉等药物治疗,24 h后逐量进食。结果本组45例中2例超过48 h,套头部位于横结肠脾曲,气压加至80 mmHg时套头部无明显移动,结合病史不排除肠坏死,未继续作复位术。43例全部行本法灌肠复位术均获成功。复位率94%--95%。其中2例进食过早12 h复发,行第二次灌肠复位亦获成功。43例（45次）术中未出现肠壁穿孔等意外发生。肠坏死特征性表现：气压升至80 mm Hg时套头部无明显运动。结论于头低足高俯卧位,利用液体石蜡、654-2的药物特征性作用提高灌肠复位率,是小儿肠套叠的理论基础。低压慢速注气是避免肠壁穿孔的重要手段。本方法简便易行、安全可靠、复位率高。Objective It is improvementing rate of child intussusception, aviodancing accident of intestinal perforation. Methods Before operation I. M one 654-2 which take the position of head lower and foot higher, insertion Faleg＇ s Canal,in the enemater set in 10-20 ml faraffinum liquidum, operator handgrips the saccule of air that takes pressure table,it is holded pressure of 80 mmhg, slower speed inflation, fluoroscopy observation air pressure propels intussuseeptum into intestinum regression out from ileoeeeal valves, the soft tissune mass image is disappearanced. The air entry the intestinal. The food and water contremdicoled 24 h after operation, for V nutrition, anti-infection, homeostasis, spasmdysis medicine care. the food is eared for number progressive multiple after 24 h. Results 2 case intussuscepted lags splenic flexure, transverse colon among 45 case. the intussusceptum migrates weaker when pressure rises to 80 mm Hg. the intestinal thanatosis could not deplete as combine disease history, it is not redact. 43 case have gained total success according to the methods, the reduction rate is 94-96%. among 43 case 2 case takes in the food caller after 12h attack, second redact acquire success too, among 43 case（45 case） operation had not occurred intestinal perforation. The tharanatosis of intestinal characteristic X-ray expression： the intussuscepted migrates weaker when air pressure rise to 80 mm Hg. Conclusion The air-max enema reduction intussusception of child uses pharmacology characteristics of 654-2 and paraffinum liquidum that ismlussuseption reduction key factors. Lower pressure and slawer speed inflation air esseatial the methods to avoidance intestinal perforation. The methods simplified, safely and confidence, which reduction rate is higher, developing is better.

关 键 词：液体石蜡 654-2 低压慢速 气蜡灌肠复位 肠套叠 

分 类 号：R726.5[医药卫生—儿科]