小儿肠套叠误诊原因分析及文献复习  

Misdiagnosis Analysis of Intussusception in Children and Literature Review

作　　者：刘丽梅 万光平[2] LIU Limei;WAN Guangping(Department of Pediatrics,Maternal and Child Health and Family Planning Service Center,Dongpo District,Meishan,Sichuan 620010,China;Department of Pediatrics,Meishan People's Hospital,Meishan,Sichuan 620010,China)

机构地区：[1]眉山市东坡区妇幼保健计划生育服务中心儿科,四川眉山620010 [2]眉山市人民医院儿科,四川眉山620010

出　　处：《临床误诊误治》2024年第21期19-23,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨小儿肠套叠误诊原因及防范措施。方法回顾性分析2021年3月至2024年3月收治的3例小儿肠套叠的临床资料。结果本组中1例呕吐,1例腹痛、排黏液血便,1例腹泻,分别误诊为胃炎、肠炎、细菌性痢疾,予以对症支持治疗效果不佳。3例均经腹部超声检查确诊为肠套叠。误诊时间为2~4 d。确诊后2例予以灌肠复位及手术治疗好转后出院,随访3个月未复发;另1例转至上级医院行肠部分切除术及吻合术治疗,痊愈出院。结论肠套叠早期症状不典型,易误诊,需结合患儿症状、病史、体格检查、腹部X线透视及超声检查进行诊断,以减少误诊。Objective To explore the causes and preventive measures of misdiagnosis of intussusception in children.Methods The clinical data of 3 children with intussusception treated from March 2021 to March 2024 were retrospectively analyzed.Results In this group,1 patient with vomiting,1 patient with abdominal pain and excretion of mucous blood stool and 1 patient with diarrhea were misdiagnosed with gastritis,enteritis and bacillary dysentery,respectively,which did not respond well to symptomatic treatment.All 3 patients were confirmed with intussusception by abdominal ultrasonography.The duration of misdiagnosis was 2-4 d.After diagnosis,2 patients were discharged from hospital after enema reduction and surgical treatment,and no recurrence was observed at 3-month follow-up.The other patient was transferred to a superior hospital for partial resection and anastomosis,and was discharged after recovery.Conclusion Intussusception has no typical symptoms in the early stage,which is prone to misdiagnosis.The diagnosis should be combined with the symptoms,medical history,physical examination,abdominal X-ray and ultrasound,which is helpful to reduce misdiagnosis.

关 键 词：肠套叠 误诊 胃炎 肠炎 痢疾 灌肠 超声检查 儿童 

分 类 号：R574.3[医药卫生—消化系统]