实时超声监护下手法复位小儿肠套叠的临床意义

目的 探讨实时超声监护下小儿肠套叠患者手法复位的临床价值。方法 对103例经超声检查确诊为小儿肠套叠患者进行动态观察，并在实时超声监护下以套头为起点用探头轻柔加压按摩，观察有无肠蠕动、套筒有无缩短或消失。按肠套包块大小、套筒长度、年龄分组分析观察结果，并与X线高压空气灌肠比较。结果 共有50例(48.5％)肠套叠患儿超声下复位成功，复位率与包块大小、套筒长度及患儿的年龄（合作程度）有关,1h后复查39例治疗成功。对于包块直径＜2.0 cm者，超声监护下手法复位率明显高于X线高压空气灌肠。结论实时超声监护下手法复位对小儿肠套叠近一半患儿起到直接治疗作用，明显降低了灌肠复位等其他治疗人数，减轻了患儿的痛苦和医疗费用，并可作为灌肠等其他治疗的筛查。

Clinical singnificance of manipulative reduction monitored by ultrasound for the treatment of intussusception in children

Objective To investigate the value of the manipulative reduction monitored by ultrasound for the intussusception of children.Methods One hundred and three intussusception children were dynamically observed by ultrasound,and were pressed softly beginning with the head of the intussusceptum,and observed whether there was intestinal peristalsis, and whether the intussuseeptum shortened and disappeared finally.The results were analyzed based on the size of the masse, the length of the intussusceptum,and the patients' age,and compared with the X-ray high pressure air enema.Results Fifty (48.5 ％) intussusception children were recovered.The recoverability was related to the size of the mass, the length of the intussusceptum, and the age of the children (level of cooperation).Thirty-nine patients were recovered after reexamined one hour later.The recoverability of manipulative reduction monitored by ultrasound for the mass diameter less than 2.0 cm was obviously higher than that by X-ray high pressure air enema.Conclusions Manipulative reduction monitored by ultrasound could cure almost half of the intussusception children patients directly.It could decrease the number of patients who were treated with high-pressure air enema,it could relieve the pain of the children and reduce their medical expenses.It also could be acted as a screening way to other therapies like high pressure air enema.