山莨菪碱在小儿空气灌肠整复急性肠套叠中的价值研究

目的 寻找提高小儿急性肠套叠空气灌肠复位成功率的方法，探讨山莨菪碱(654-2)在空气灌肠整复小儿急性肠套叠中的应用价值。方法 将临床疑诊急性肠套叠需作空气灌肠确诊的患儿共137例按就诊顺序分为两组，A组患儿空气灌肠前肌注654-2，B组患儿空气灌肠前未肌注654-2，根据复位指征对A组的67例患儿及B组的65例患儿进行了空气灌肠复位，观察和比较两组的复位成功率及已复位病例的平均复位时间。B组复位未成功病例肌注654-2后5min再重新进行复位。结果 A组63例复位成功，成功率94．03％，B组57例复位成功，成功率87．69％，肌注654-2后再行复位又有4例获得成功，最终成功率93．85％。A组整复病例，平均复位时间7．14min，B组整复病例，平均复位时间12．37min,，A组复位成功率较未肌注654-2的B组高，与B组最终成功率接近，A组整复病例平均复位时间较B组常规复位平均时间短。结论 整复前肌注654-2有助于提高小儿急性肠套叠空气灌肠整复的成功率及缩短整复时间，在临床应用中可考虑推广使用。

The application value of 654-2 in the treatment of acute child intussusception with air pressure enema

Objective To explore a method which can improve the success rate of air pressure enema treatment in children of acute intussusception and to evaluate the effect of 654-2 in this study.Methods 137 children suscepted as acute intussusception were divided into A group and B group according to the sequence of out-patient clinic.Children of A group were muscular injected 654-2 before air pressure enema and B group were not.We selected 67 children in A group and 65 children in B group as our study cases according to the indication of replacing with air pressure enema.The success rate and the average replacing time of success cases were compared between A and B group.Failure cases in B group were also muscular injected 654-2 before the second air reduction.Results 63 cases in A group and 57 cases in B group were replaced successfully.The success rate was 94.03%(63/67) in A group and 87.69%(57/65) in B group.The average time of replacing was 7.14min in A group and 12.37min in B group.While repeating the air reduction in the failure cases of B group after muscular injected 654-2,we acquired success in 4 cases.Eventually,the success rate was 93.85%(61/65) in B group.Conclusion The application of 654-2 before replacing can improve the success rate for child intussusception in reduction with air pressure enema and shorten the time of replacing,it is worth applying in routine clinical practices.