中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2013年
11期
819-822
,共4页
儿童%肠套叠
兒童%腸套疊
인동%장투첩
Child%Intussusception
目的 探讨大于3岁儿童继发性肠套叠的临床特点和发病原因,提高儿童肠套叠的诊治水平.方法 回顾性总结重庆医科大学附属儿童医院2001～2011年收治的大于3岁儿童继发性肠套叠,分析其临床表现、发病原因及诊疗情况.结果 82例患儿腹痛80例,呕吐56例,血便34例,腹部扪及包块31例.82例中过敏性紫癜48例(58.8％),肠息肉9例(11.0％)、梅克尔憩室7例(8.5％)、肿瘤5例(6.1％),其他13例.63例行空气灌肠复位治疗,28例成功,平均压力7.7 kPa.54例手术治疗,术中见回结型18例,回回型11例,回盲型8例,空空型4例,回回结型4例,结结型4例,自动复位5例;肠坏死14例.结论 大于3岁儿童继发性肠套叠比例随年龄增加而增加,过敏性紫癜是主要继发因素.病程大于3d或者反复发生肠套叠者需警惕继发性肠套叠;病程超过14d需警惕肠道肿瘤.儿童肠套叠继发于过敏性紫殿时,空气灌肠是安全、有效的治疗方法.肠套叠由器质性病变引起时,手术去除病变是主要治疗手段.
目的 探討大于3歲兒童繼髮性腸套疊的臨床特點和髮病原因,提高兒童腸套疊的診治水平.方法 迴顧性總結重慶醫科大學附屬兒童醫院2001～2011年收治的大于3歲兒童繼髮性腸套疊,分析其臨床錶現、髮病原因及診療情況.結果 82例患兒腹痛80例,嘔吐56例,血便34例,腹部捫及包塊31例.82例中過敏性紫癜48例(58.8％),腸息肉9例(11.0％)、梅剋爾憩室7例(8.5％)、腫瘤5例(6.1％),其他13例.63例行空氣灌腸複位治療,28例成功,平均壓力7.7 kPa.54例手術治療,術中見迴結型18例,迴迴型11例,迴盲型8例,空空型4例,迴迴結型4例,結結型4例,自動複位5例;腸壞死14例.結論 大于3歲兒童繼髮性腸套疊比例隨年齡增加而增加,過敏性紫癜是主要繼髮因素.病程大于3d或者反複髮生腸套疊者需警惕繼髮性腸套疊;病程超過14d需警惕腸道腫瘤.兒童腸套疊繼髮于過敏性紫殿時,空氣灌腸是安全、有效的治療方法.腸套疊由器質性病變引起時,手術去除病變是主要治療手段.
목적 탐토대우3세인동계발성장투첩적림상특점화발병원인,제고인동장투첩적진치수평.방법 회고성총결중경의과대학부속인동의원2001～2011년수치적대우3세인동계발성장투첩,분석기림상표현、발병원인급진료정황.결과 82례환인복통80례,구토56례,혈편34례,복부문급포괴31례.82례중과민성자전48례(58.8％),장식육9례(11.0％)、매극이게실7례(8.5％)、종류5례(6.1％),기타13례.63례행공기관장복위치료,28례성공,평균압력7.7 kPa.54례수술치료,술중견회결형18례,회회형11례,회맹형8례,공공형4례,회회결형4례,결결형4례,자동복위5례;장배사14례.결론 대우3세인동계발성장투첩비례수년령증가이증가,과민성자전시주요계발인소.병정대우3d혹자반복발생장투첩자수경척계발성장투첩;병정초과14d수경척장도종류.인동장투첩계발우과민성자전시,공기관장시안전、유효적치료방법.장투첩유기질성병변인기시,수술거제병변시주요치료수단.
Objective To explore the clinical characteristics of secondary intussusception in children ＞3 years old and to improve the diagnostic capacity.Methods We retrospectively reviewed intussusception cases in children ＞3 years old admitted during 2001-2011.Clinical manifestations,etiologies and clinical courses were studied.Results Eighty-two confirmed cases were collected.Eighty cases manifested with abdominal pain,56 cases with vomiting,34 cases with hematochezia,and 31 cases with abdominal mass.Forty-eight cases (58.8％)were caused by Henoch-Schonlein purpura,9 cases (11.0％) by intestinal polyp,7 cases (8.5％) by Meckel's diverticulum,5 cases (6.1％) by tumor,and 13 cases by others.Air enema was performed in 63 cases with 28 cases successful.Surgery was performed on 54 cases.Ileocolic intussusception were seen in 18 cases,ileoileal in 11 cases,ileocecal in 8 cases,ileoileocolic in 4 cases,jejunojejunal in 4 cases,colocolic in 4 cases,and spontaneous reduction in 5 cases.Intestinal necrosis was found in 14 cases.Conclusions Secondary intussusception is hard to diagnose in children over 3 years old.Intussuscepiton lasting more than 3 days or repeated intussusception should have secondary causes investigated.Although air enema is a safe and effective treatment of secondary intussuception,surgery remains the main treatment.
