婴幼儿肠套叠空气灌肠127例整复最佳时机探讨  

Exploration of the optimal time for air enema reduction of infant intussusception—analysis of 127 cases

作　　者：陈晓林[1] 鲁开文[1] 周建雄[1] 覃晓燕[1] 

机构地区：[1]三峡大学第一临床医学院/宜昌市中心人民医院,湖北宜昌443003

出　　处：《现代医药卫生》2013年第16期2422-2423,2425,共3页Journal of Modern Medicine & Health

摘　　要：目的分析影响婴幼儿肠套叠空气灌肠整复失败的因素,提高婴幼儿肠套叠空气灌肠的整复成功率。方法回顾性分析2002年1月至2012年8月收治的婴幼儿肠套叠127例,X射线下空气灌肠整复对所有患儿的整复率与病程、套叠部位、套头大小及回缩情况、全身状况(发热、脱水)的关系进行分析。结果 127例患儿中空气灌肠整复成功99例,成功率为78.0%,失败病例均经手术整复。病程小于或等于48 h者整复成功率为83.3%(50/60),>48～72 h为73.1%(49/67),二者比较,差异有统计学意义(P<0.01);套叠部位在横结肠中段近侧者整复成功率为84.0%(63/75),结肠脾曲至乙状结肠者整复成功率为69.2%(36/52),二者比较,差异有统计学意义(P<0.01)。反复加压套头大小无变化者难复位,患儿病程长(>48 h),全身情况差、有发热、脱水程度重者难复位。结论充分掌握婴幼儿肠套叠的临床特征,临床医生与放射科医生共同协作,尽早进行空气灌肠既能明确诊断,又能提高空气灌肠整复成功率。Objective To analyze the factors leading to failure of air enema reduction in infant with intussusception,and to improve the successful rate of induction.Methods 127 infants with intussusception received from January to August 2012 were analyzed retrospectivly.The relationships of air anema reduction under X-ray with the reduction rate and the course of the disease,the site of intussusception,the size of sheath section,and systemic conditions（fever,dehydration） of the patients were analyzed.Results The success rate of air enema reduction was 78.0% in whole 127 cases（99/127）,and the failure cases were all with surgical treatment.The success rate was 83.3%（50/60） in the cases duration less than or equal to 48 h,and the rate was 73.1%（49/67） in cases onset between 48 h and 72 h,and the difference between the two periods of time had statistical significance（P0.01）.The success rate was 84.0%（63/75） in cases with intussusception in proximal transverse colon middle part,while the rate was 69.2%（36/52） in cases with intussusception between splenic flexure to sigmoid,and the difference between the two parts had statistical significance（P0.01）.There were difficult reduction in cases of no change on the hedging size after repeated pressurization,longer duration more than 48 hours,poor general condition with fever and severe degree of dehydration.Conclusion Mastery the clinical features of the disease,and carring out air enema together by clinicians and radiologists as soon as possible can define diagnosis and improve the success rate of air enema reduction.

关 键 词：X线透视检查 肠套叠 灌肠 空气 整复 婴幼儿 

分 类 号：R726.56[医药卫生—儿科]