小婴儿肠套叠临床及诊治特点  

Clinical features and non-operative management of intussusception in young infants

作　　者：李京恩[1] 汪健[2] 盛茂[1] 刘玉奇[1] 郭万亮[1] 

机构地区：[1]苏州大学附属儿童医院放射科,215003 [2]苏州大学附属儿童医院普外科,215003

出　　处：《中华小儿外科杂志》2015年第11期833-835,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的提高对小婴儿肠套叠的临床特征以及非手术治疗特点的认识。方法收集我院2008年至2013年间108例小婴儿急性肠套叠患儿的资料，对其临床表现、诊治经过进行回顾性分析。采用统计学方法来评估影响小婴儿肠套叠空气灌肠肠套叠复位成功的重要因素。结果小婴儿肠套叠的空气灌肠复位成功率仅为50．0%（54／108），同期大婴儿肠套叠的复位成功率为94．1％（7317／7773），两组比较，差异有统计学意义（x^2=158．0285，P〈0．001）。病程长短、有无血便、肠管血运障碍及空气灌肠时肠套叠套头的位置及形态对空气灌肠复位是否成功有统计学意义（P〈0．05）。结论小婴儿肠套叠应尽可能进行空气灌肠整复尝试，但应根据患儿的病程、精神状态、血便情况并结合有无血运障碍、肠套叠套头的形态、位置来综合判断，选择适宜的灌肠压力。Objective To explore the clinical features and non-operative management of intussusception in young infants. Methods A total of 108 young infants with ultrasonically confirmed intussusception at our hospital between 2008 and 2013 were recruited. Their clinical features, diagnosis and treatment options were analyzed retrospectively. Results The success rate of air enema reduction was 50% （54/108） in young infants versus 94. 1% （7317/7773）in elder counterparts. And the success rate was significantly lower in young infants than that in control group （x^2 = 158. 0285,P 〈0. 001 ）. The course of disease, bloody tool, impaired intestinal blood circulation, shape of intussusception and mass location were associated with a lower likelihood of successful air enema reduction. Conclusions Upon a definite diagnosis of intussusception in young infants, air enema reduction is the first-line treatment option. And appropriate pressure of air enema should be maintained for avoiding such serious complications as intestinal perforation and peritonitis.

关 键 词：肠套叠 婴儿 空气灌肠 

分 类 号：R726.5[医药卫生—儿科]