小儿肠套叠的影像诊断与整复及整复失败原因的分析

目的 :提高对小儿肠套叠的影像诊断与治疗的认识。方法 :回顾性分析近 15年经空气灌肠证实的肠套叠患儿 6 0 8例的影像学表现。其中 5 5 0例经透视下行结肠注气整复成功 ,5 8例整复失败经手术复位。结果 :空气灌肠整复失败 5 8例中 ,术后病理证实有复杂型 2 8例 ,器质性肠套叠 2例 ,肠壁损伤 2 1例 ,3例阑尾被套 ,4例肠坏死 ,其中回 -回 -结套 2 4例 ,回 -结套 2 4例 ,回回结结型 4例。结论 :透视下空气灌肠是诊断与治疗小儿肠套叠的最好方法 ;对于复杂型肠套叠及伴有肠管畸形、肠腔坏死等症 ,则应尽早采取手术治疗。

Causes Account for the failure of air enema in the reduction of Intussusception in children And X - RAY Diagnosis of Intussusception in children

Objective: To improve the knowledge about the X-ray feature and the treatment of Intussusception.Methods: Of the 660 cases,550 cases were successfully reduced by air enema .Fifty-eight unreduced cases were cured by operation .The X-ray findings in all 608 cases in the past 15 years were analyzed and reviewed.Results: Successful operation was done in 58 cases unsuccessful by air enema,which included complex intussusception(n=28),organic intussusception(n=2),intestinal injury(n=21),involvement of appendix (n=3)and bowel necrosis was seen in 4 cases. Proved by operation pathology,ileoilecolic intussusception in 24 cases.Conclusion: Air-pressure enema examinations is the best methods in treat and diagnose intussusception .Complex intussusception ,with intestinal malformation and bowel necrosis,are difficult to reduce ,and these patients ought to be operated on time.