小儿肠套叠气灌肠未整复病例的临床及腹部X线片分析  

Analysis of the clinical and X-ray features of the air enema unreduced intussusception in children

作　　者：曾津津[1] 孙国强[1] 宁可[1] 任甄华[1] 鹿松 

机构地区：[1]北京儿童医院放射科,100045 [2]山东青岛市儿童医院放射科

出　　处：《中华放射学杂志》2001年第9期686-688,共3页Chinese Journal of Radiology

摘　　要：目的　提高对气灌肠无法复位或有肠穿孔危险的婴儿肠套叠X线表现的认识。方法1 995～ 1 996年间 552例肠套叠中 50 6例经气灌肠整复 ,46例未整复成功经手术治疗 (其中 4例整复时穿孔 )。 46例患儿中小于 1岁者占 87%。约 90 %患儿发病时间短于 3d ,整复压力 6.67～ 1 4.67kPa(60～ 1 1 0mmHg)。对气灌肠前及灌肠整复时腹部平片对照手术病理进行回顾性分析。结果　 (1 )腹平片示完全性小肠梗阻 2 6例 ,少量腹水征 4例 ;(2 )气灌肠见 2 2例包块位于结肠脾区远端 ,3 6例包块较大且有明显分叶 ;(3 )手术病理 :回 回套 1例 ,回 回 结套 3 5例 ,回 结套 1 0例 ;1 5例有肠坏死 ;6例套入头部有原发病变。结论　 92 %以上小儿肠套叠可经气灌肠整复 ,如发现复杂性肠套叠、有原发病变或合并肠坏死的X线征象时则不宜复位 。Objective To analyze the X ray findings of enema unreduced (including 4 perforations ) intussusception so as to improve the knowledge about the difficulty of reduction by air enema or the risk of perforation. Methods Of the 552 cases, 506 cases were successfully reduced by air enema. The range of air pressure was 6.67 to 14.67 kPa(60～110 mm Hg). Forty six unreduced cases were cured by operation. The films were taken before and during the reduction period. X ray findings were analyzed compared with that of the operative pathology. Results (1)Abdominal plain films showed total obstruction in 26 cases and asctis in 4 cases; (2) Air enema showed big and lobular masses in 36 cases and the location of masses in distal part of colon in 22 cases; (3)Operation pathology: ileoilecolic intussusception in 35 cases, 15 cases with intestinal necrosis (including 4 perforation cases). In 3 cases, perforations were in the intussusceptum,the other in the intussuscipiens. Conclusion 92% of intussusceptions can be reducted by pressure of air enema. Complex intussusception, with intestinal necrosis and primary intussusceptum, are difficult to reduce, and these patients ought to be operated on time.

关 键 词：肠套叠 放射摄影术 儿科学 

分 类 号：R816.92[医药卫生—放射医学]