ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2016, Vol. 8 ›› Issue (5): 517-519.doi: 10.3969/j.issn.167-43865.2016.04.019

• 临床研究 • 上一篇    下一篇

儿童肠套叠839例诊治体会

徐丰,郭春娜   

  1. 475000 河南 开封,开封市儿童医院外一科(徐丰),病理科(郭春娜)
  • 出版日期:2016-10-25 发布日期:2017-12-08
  • 通讯作者: 郭春娜,E-mail:28007942@qq.com
  • 作者简介:徐丰(1983-),男,主治医师。研究方向:小儿外科疾病的诊治

Diagnosis and treatment of 839 cases of intussusception in children

XU Feng,GUO Chunna   

  1. Kaifeng Children's Hospital,Kaifeng 475000,China.
  • Online:2016-10-25 Published:2017-12-08

摘要:
目的:探讨儿童肠套叠的临床表现及诊治体会。
方法:分析本院2013年1月至2016年1月经B超确诊为肠套叠839例患儿的病例资料。
结果:839例患儿中男599例,女240例,男女比例为2.5∶1;758例空气灌肠整复成功,81例患儿手术复位,空气灌肠整复成功率为90.3%,86例患儿肠套叠复发,复发率为10.2%,再次空气灌肠85例成功,复发灌肠成功率为98.8%;病理方面:原发性肠套叠805例,继发性肠套叠34例(息肉引起肠套叠5例,梅克尔憩室20例,肠重复畸形3例,过敏性紫癜6例);术中发现肠坏死33例,术后均由病理确诊。
结论: 空气灌肠整复术是治疗儿童肠套叠的有效方法,整复术失败需及时手术,避免肠管坏死;对于多次反复肠套叠的患儿需考虑回盲部解剖异常和继发性肠套叠的可能性;患儿出现肠坏死与套叠类型及发病时间长短有关。

关键词: 肠套叠, 空气灌肠整复术, 外科手术, 儿童

Abstract:


Objective :To study the clinical manifestations and diagnosis and treatment of intussusception in children.
Methods: Analysis the clinical data of 839 cases of intussusception in children diagnosed by B ultrasound between Jan. 2013 and Jan. 2016.
Results: Among the 839 cases, 599 were male and 240 were female, the ratio of male to female being 2.5∶1. Air enema reduction was successful in 758 cases, the success rate being 90.3%; 81 children were successfully treated by surgery; intussusception relapse occurred in 86 cases, with the recurrence rate being 10.2%, who received air enema reduction again and 85 were successfully treated, the success rate being 98.8%. In the pathological aspect: there were 805 cases of primary intussusception, 34 cases of secondary one(polyps in 5 cases, Meckel's diverticulum in 20 cases, intestinal duplication in 3 cases and allergic purpura in 6 cases). Intestinal necrosis was found in 33 cases during surgery, which was confirmed by pathology after surgery.
Conclusion: Air enema reduction is an effective treatment for children with intussusception. Timely surgery is recommended in case of reduction failure in order to avoid intestinal necrosis. For the children with repeated intussusception, there may be the possibility of abnormal anatomy of ileum and cecum and secondary intussusception. Intestinal necrosis is related to the type and length of time of intussusception.

Key words: Intussusception, Air enema reduction, Surgery, Children