小儿肠套叠空气灌肠和水压灌肠复位的对比分析 下载本文

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小儿肠套叠空气灌肠和水压灌肠复位的对比分析

[摘要] 目的分析小儿肠套叠空气灌肠和水压灌肠复位的疗效。方法回顾性分析该院自2014年6月―2016年6月期间经B超检查确诊的332例肠套叠患儿,分别按入院时单月份施行空气灌肠复位法和双月份施行水压灌肠复位法,比较两组复位成功率,复位时间,复套率,大便隐血恢复正常?r间。结果空气灌肠和水压灌肠复位治疗小儿肠套叠在复位成功率(96.3% vs 98.1%),复套率(18.3% vs 15.6%),大便隐血恢复正常时间[(2.1±1.3)d vs (1.8±1.5)d]上差异无统计学意义(P>0.05),但空气灌肠时间明显短于水压灌肠时间[(5.6±2.4)min vs (10.8±4.2)min]。结论超声监视下行水压灌肠复位成功率不低于空气灌肠,且便于监测,了解病情变化,即便多次复套后仍可重复复位。且没有辐射损伤,以患儿为中心,推荐超声监视下水压灌肠复位。

[关键词] 空气灌肠;水压灌肠;肠套叠;疗效 [中图分类号] R726 [文献标识码] A [文章编号] 1674-0742(2016)12(b)-0094-03

Comparative Analysis of Air Enema and Enema Reduction of Intussusception in Children

ZOU Jia-liang, XU Hui-feng, XIA Fan, LIN Yu-ting, LIU

Yun-qin

Department of Pediatric Surgery, Xiamen Children's Hospital, Xiamen,Fujian Province, 351000 China [Abstract] Objective To investigate the curative effect of air enema and enema reduction of intussusception in children. Methods A retrospective analysis of 332 cases of

intussusception in our hospital from June 2014 to June 2016 during the B-ultrasound diagnosis, respectively, according to the admission single month implementation of air enema reduction method and double month underwent reduction of hydrostatic enema method, comparison of two groups of the reduction rate, reduction time, recovery rate, recovery time of fecal occult blood. Results Air enema and enema reduction of intussusception in children (96.3% vs 98.1%) in the success rate of reduction,double rate of (18.3% vs 15.6%), fecal occult blood recovery time [(2.1 ± 1.3)d vs (1.8 ± 1.5)d] have no obvious difference(P>0.05), but the air enema time was shorter than the water pressure enema time [(5.6 ± 2.4)min vs (10.8 ± 4.2)min]. Conclusion The success rate of hydraulic pressure enema reduction is not less than air enema, and it is convenient to monitor and understand the change of the condition. And there was no radiation injury,

with the children as the center, recommended ultrasound monitoring of water pressure enema reduction.

[Key words] Air enema; Enema; Intussusception; Curative effect

肠套叠是小儿外科最为常见的急腹症之一,多见于2岁以下婴幼儿,尤其是4~10个月婴儿。肠套叠常突然起病,临床中有少数患儿由于诊治不当导致肠穿孔、肠坏死等严重并发症,甚至引起患儿死亡[1]。目前,非手术灌肠复位是诊治肠套叠的最主要方式,复位成功率超过90%[2]。回顾性分析该院自2014年6月―2016年6月期间收治332例急性肠套叠患儿分别采用空气灌肠复位与水压灌肠复位治疗资料进行对比,现报道如下。 1 资料与方法 1.1 一般资料

方便选取并分析该院收治的332例小儿急性肠套叠患者,临床表现为腹痛、呕吐、便血和腹部肿块,其中腹痛占96%、呕吐占90%,便血占70%,腹部包块占62%,162例表现为阵发性哭闹、呕吐、便血以及腹部肿块四联征。将所有患者按入院时单双月份随机分为观察组(空气灌肠组)和对照组(水压灌肠组),观察组病例:男性110例,女性57例,年龄3个月~8岁,平均13个月,病程5~42 h,平均(9.2±4.3)h;对照组病例:男性102例,女性63例,年龄4个月~