空气灌肠诊治小儿肠套叠128例临床体会

目的：探讨小儿肠套叠的诊断和治疗措施,总结空气灌肠诊治小儿肠套叠的临床应用体会,提高小儿肠套叠的诊断治愈率。方法：对128例肠套叠使用日本岛津80 kW数字胃肠机及国产JS-818电脑遥控灌肠整复仪,先低压（6～7 kPa）灌肠确诊肠套叠存在,复位压力控制在8～14 kPa,依整复进程逐渐增压,每次增压为1 kPa,其最高压力≤l4 kPa。整复成功5～10 min后行腹部立位透视,排除肠穿孔等并发症。结果：本组128例成功复位122例,成功率为95.31%,失败6例。未发生肠穿孔等并发症。本组病例复位成功与病程时间密切相关,整复成功率随病程时间的延长而递减,而套叠的深度不是整复失败的主要因素。结论：空气灌肠整复小儿肠套叠方法简便,安全可靠,整复成功率高,可重复操作性强,是目前小儿肠套叠常用和首选的诊治方法,严格掌握适应证,选择恰当的灌肠整复方法和控制整复压力,在电视透视监视进行整复可有效防止并发症的发生。

Air enema treatment clinical experience of 128 cases of intussusception in children

Objective： To investigate the diagnosis and treatment of pediatric intussusception measures, summed up the air enema intussusception diagnosis and treatment of pediatric clinical experience, improve the cure rate of children with the diagnosis of intussusception. Methods： 128 cases of intussusception using shimadzu 80 kW machine and the number of gastrointestinal JS-818 made enema device remote computer, the first low-voltage （6 to 7 kPa） enema intussusception confirmed the existence of reset pressure control in the 8 to 14 kPa, according to the entire complex process of gradually pressurized, each pressurized to 1 kPa, the maximum pressure ≤ 14 kPa. After the success of the entire complex underwent abdominal 5 to 10 minutes orthostatic perspective, exclude complications such as intestinal perforation. Results： 128 cases 122 cases successfully reset, the success rate was 95.31%, failed in 6 cases. Complications such as intestinal perforation has not occurred. Reset this group of patients was closely related to success and duration of time, the success rate of restoration time with the disease and decreasing the depth of the overlay was not a major factor in the failure of the entire complex. Conclusion： Air enema intussusception in children is simple, safe and reliable restoration success rate, repeatable and feasible, is the pediatric intussusception diagnosis and treatment of common and preferred method, strict indica- tions, select the appropriate enema restoration methods and control the entire complex pressure in the entire complex fluoroscopic monitoring can prevent complications.