CAJ | 학술논문

目的：探讨小儿急性肠套叠灌肠复位术后早期复发的原因及处理。方法回顾性分析48例急性肠套叠灌肠复位术后早期复发的临床资料，特别是灌肠时的X线资料，并提出相应处理方法。结果早期复发组与无复发组在患儿的性别、年龄、就诊时间及灌肠压力方面比较，差异无统计学意义(字2均<3.84，P>0.05)，而在①就诊时照片有无肠梗阻X线征象、②复位后起套部仍是否可见、③解除压力后起套部是否变大及榆复位后小肠充气情况等比较，差异有统计学意义(字2均>3.84，P<0.05)，复发组均选择再次灌肠复位处理。结论肠套叠空气灌肠复位后早期仍需注意复发或多次复发可能，灌肠时多次反复变换体位观察，特别注意灌肠起套部变化是减少复发和保证再次灌肠成功的关键因素之一，掌握好适应证，可选择再次空气灌肠。
목적：탐토소인급성장투첩관장복위술후조기복발적원인급처리。방법회고성분석48례급성장투첩관장복위술후조기복발적림상자료，특별시관장시적X선자료，병제출상응처리방법。결과조기복발조여무복발조재환인적성별、년령、취진시간급관장압력방면비교，차이무통계학의의(자2균<3.84，P>0.05)，이재①취진시조편유무장경조X선정상、②복위후기투부잉시부가견、③해제압력후기투부시부변대급유복위후소장충기정황등비교，차이유통계학의의(자2균>3.84，P<0.05)，복발조균선택재차관장복위처리。결론장투첩공기관장복위후조기잉수주의복발혹다차복발가능，관장시다차반복변환체위관찰，특별주의관장기투부변화시감소복발화보증재차관장성공적관건인소지일，장악호괄응증，가선택재차공기관장。
Objective To explore the reasons and management of early relapse of pediatric acute intussusception after enema reduction. Methods Clinical data of 48 patients with early relapse of pediatric acute intussusception after enema reduction were retrospectively collected and analyzed, especially for X-ray data during enema. Relevant management methods were proposed. Results In the comparison of gender, age, admission time and enema pressure between the early relapse group and non-relapse group of children patients, without statistically significant differences(χ2 all <3.84,P>0.05). However, as for①whether X-ray sign of intestinal obstruction could be seen during diagnosis,②whether intus-suscepted parts could be clearly seen after reduction, ③whether intussuscepted parts became larger after pressure re-lief, and ④inflation of small intestine after reduction compared between the two groups, with statistically significant differences (χ2 all>3.84,P<0.05). Patients in the relapse group were all given a secondary enema reduction. Conclu-sion During early stage after reduction of intussusception by air enema, possibilities of relapse or multiple relapses should still be noticed. Observations of multiple repeated changes of body position during enema and special attention to changes of intussuscepted parts are one of critical factors for reducing relapses and ensuring a success for secondary enema. A secondary air enema can be carried out when mastering the indications.