彩超监控引导温盐水灌肠复位术治疗小儿肠套叠的临床研究

目的 探讨彩超监控引导下温盐水灌肠复位术治疗小儿肠套叠的临床治疗效果。 方法 回顾性分析蚌埠医学院第一附属医院2015年1月—2020年4月期间行彩超监测引导下温盐水灌肠复位术治疗的112例肠套叠患儿的临床资料。在彩超监视引导下安全压力范围内向肠管内注入温盐水,高频与低频彩超交替观察肠套复位,彩超所显示的回盲瓣的开放、包块消失及小肠进水3种影像表现均是证实复位成功的指标,具备以上3个指标的一条或者多条均可证实复位成功。 结果 患儿复位成功107例,复位成功率为95.54%;复位不成功5例,复位不成功率为4.46%。患儿的平均住院时间为(3.26±0.18)d,复位后患儿口服炭片,经肛排出,再次证实复位成功;复位成功后出现发热症状(>37.3℃)8例,术后出现腹泻症状23例,给予相应的对症支持治疗后全部治愈出院。复位不成功的5例患儿及时进行开腹手术治疗,也均痊愈出院。出院后2周内均进行随访,患儿无复发情况。 结论 彩超监控引导下温盐水灌肠复位术治疗小儿肠套叠复位成功率高,具有安全、可靠、复位成功率高及无辐射的优点,值得临床推广应用。 

Clinical study on the treatment of intussusception in children by warm saline enema guided by color doppler ultrasound

Objective To investigate the clinical therapeutic effect of warm saline enema reduction in the treatment of intussusception in children under the guidance of color ultrasound monitoring. Methods A retrospective analysis of our hospital in recent years do colour to exceed monitoring guided by salt water enema reduction treatment of the clinical data of 112 cases of children with intussusception, in colour to exceed guided by monitoring safety pressure within insufflate the saline injection temperature, high frequency and low frequency alternating colour to exceed to observe intestinal reset, colour to exceed shows blind valve open, back bag piece disappear and small intestine fill three images are confirmed reset indicators of success, with the above three indicators are confirmed one or more restoration success. Results The reduction success rate was 95.54% in 107 cases. The failure rate of reduction was 4.46% in 5 cases. The average length of stay was(3.26±0.18) d. After the reduction, the children were given oral carbon tablets, which were discharged through anus, and the reduction was confirmed again. There was no recurrence at 2 weeks' follow-up. Among the 8 cases with fever(>37.3 ℃) after successful reduction, 23 cases had diarrhea after surgery. All of them were cured and discharged after receiving corresponding symptomatic support treatment. Five cases were treated by open abdominal surgery in time and all recovered. The patients were followed up within 2 weeks after discharge, and there was no recurrence. Conclusion The reduction success rate of children intussusception treated by warm saline enema under the guidance of color ultrasound monitoring is high, which has the advantages of safety, reliability, high reduction success rate and no radiation.