摘要
目的探讨小儿肠套叠超声引导下水压灌肠复位术后复发的原因、治疗方法及疗效。方法回顾性分析大理州妇幼保健院2014年1月至2020年12月水压灌肠复位后复发的43例小儿肠套叠的临床资料。结果43例肠套叠患儿共复发50次,其中复发1次39例、2次2例、3次及4次各1例。复位成功至复发的间隔时间为(15.20±9.24)h,24 h内复发41次(82.00%),24~48 h复发8次(16.00%),超过48 h复发1次(2.00%)。在复发肠套叠的临床表现中,阵发性腹痛(哭闹)、呕吐、腹部包块与首次发病时比较,差异无统计学意义(P>0.05),但血便的例数较首次发病时少(P<0.05)。首次发病时白细胞(WBC)升高19例,超敏-C反应蛋白(hs-CRP)升高18例;首次发病及复发时43例患儿超声检查均可见“同心圆征”或“靶环”状包块影,发现肠系膜淋巴结肿大28例,复发时肠套叠的同心圆直径较首次发病时小(P<0.05);复发时灌肠时间较首次灌肠时短(P<0.05)。43例患儿中,反复水压灌肠复位治愈41例(94.12%),手术治愈2例,肠穿孔0例。结论小儿肠套叠超声引导下水压灌肠复位后复发多为早期复发,复发原因尚不明确,复发后继续给予水压灌肠复位,操作简便、可反复多次复位、复位成功率高、并发症少,家属接受程度高,临床易推广。
Objective To explore the causes,therapeutic method and treatment effect of recurrence of intussusception in children after hydrostatic reduction guided by ultrasonography.Methods The clinical data of 43 children with recurrence of intussusception after reduction by hydraulic enema from January 2014 to December 2020 in Maternal and Child Health Center in Dali Prefecture were retrospectively analyzed.Results A total of 50 recurrences occurred in 43 children with intussusception,including 39 cases recurred once,2 cases recurred twice,1 case recurred three times,and 1 case recurred four times.The interval from successful reduction to recurrence was(15.20±9.24)h,41 recurrences(82.00%)within 24 hours,8 recurrences(16.00%)within 24-48 hours,and 1 recurrence(2.00%)over 48 hours.In the clinical manifestations of recurrent intussusception,there were no significant differences in paroxysmal abdominal pain(crying),vomiting,and abdominal mass compared with the first onset(P>0.05),but the number of bloody stools was fewer than that at the first onset(P<0.05).When 43 children with intussusception had their first onset,19 children had elevated white blood cells(WBC)and 18 children had elevated high sensitivity C-reactive protein(hs-CRP).Ultrasonography of 43 children at the first onset and at the time of recurrence showed“concentric circle sign”or“target ring”-like mass shadow,and 28 cases were found to have enlarged mesenteric lymph nodes.The diameter of the concentric circles of intussusception at the time of recurrence was smaller than that at the time of the first onset(P<0.05).The time of enema intussusception at the time of recurrence was shorter than that at the time of the first onset(P<0.05).Among the 43 children,41 cases(94.12%)were cured by repeated hydraulic enema reduction,2 cases were cured by surgery,and there was no intestinal perforation.Conclusion The recurrence after ultrasound guided hydrostatic reduction in children with intussusception is mostly early recurrence,and the cause of recurrence is not clear.After the recurrence of intussusception,continue to give hydraulic enema reduction,which is easy to operate,can be repeated many times,has a high reduction success rate,fewer complications,high family acceptance,and easy clinical promotion.
作者
杨龙华
杨琼
赵育军
YANG Longhua;YANG Qiong;ZHAO Yujun(Maternal and Child Health Center in Dali Prefecture,Yunnan Province,Dali 671000,China;Institute of Research and Control Schistosomiasis in Dali Prefecture,Yunnan Province,Dali 671000,China)
出处
《妇儿健康导刊》
2022年第6期71-74,共4页
JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE
关键词
肠套叠
水压灌肠
复发
小儿
Intussusception
Hydraulic enema
Recurrence
Children
