CAJ | 학술논문

目的探讨小儿肠套叠套入部血管血流动力学变化，以选择其复位方式。方法 76名肠套叠患儿均行彩色多普勒血流显像，观察套叠肠管及肠系膜动静脉的血流动力学变化，然后进行空气灌肠复位。结果空气灌肠复位成功61例，失败15例，后者行手术复位治疗。两组的动脉阻力指数差异有显著性意义。失败组的静脉流速和动脉峰速较复位成功组偏高，其中失败组1例患儿升结肠套入部无血流显示。结论根据彩色多普勒超声对小儿肠套叠的血流动力学检测，可以正确选择复位方式。肠壁严重水肿、阻力指数显著升高、无血流显示等情况禁忌空气灌肠，应尽快手术复位。
목적탐토소인장투첩투입부혈관혈류동역학변화，이선택기복위방식。방법 76명장투첩환인균행채색다보륵혈류현상，관찰투첩장관급장계막동정맥적혈류동역학변화，연후진행공기관장복위。결과공기관장복위성공61례，실패15례，후자행수술복위치료。량조적동맥조력지수차이유현저성의의。실패조적정맥류속화동맥봉속교복위성공조편고，기중실패조1례환인승결장투입부무혈류현시。결론근거채색다보륵초성대소인장투첩적혈류동역학검측，가이정학선택복위방식。장벽엄중수종、조력지수현저승고、무혈류현시등정황금기공기관장，응진쾌수술복위。
Objective　To investigate the feasibility of choosing the way of reduction according to the hemodynamics of the intussusceptive places examined by color Doppler flowing imaging(CDFI).Methods　Seventy-six cases of intussusception had the examination of CDFI. The hemodynamic changes of the invaginative intestine and the mesenteric arteries and veins were observed and air enema reduction was done in all patients.Results　Air enema reduction was perfomed successfully on 61 cases, and 15 failure cases underwent operative reduction. The resistance index (RI) was significantly different between two groups. The velocity of vein flow and the mean velocity of arterial peak in the failure group were higher than those in the success group. One case of the failure group had no flow imaging in invaginative part of ascending colon.Conclusions　Color Doppler ultrasonography is a simple and useful method in monitoring the hemodynamic changes of the children intussusception and correctly chooseing the way of reduction.Operative reduction should be performed quickly when heavily swelling intestinal wall, significantly high RI, especially no flow imaging are demonstrated in color Doppler ultrasonography.