改良空气灌肠法在小儿肠套叠的诊断和治疗的应用(附84例分析)

目的探讨改良空气灌肠法在诊治小儿肠套叠的临床应用价值。方法对我院在2000年1月至2006年12月采用改良空气灌肠法对84例小儿肠套叠的诊治资料进行回顾性分析。结果本组确诊为肠套叠84例,排除非肠套叠24例,明确诊断率为100%。复位成功79例,复位率为94.28%。复位未成功并手术治疗5例,其中3例是肠坏死1例为回回结肠型肠表叠,1例为Meckle憇室。复位后无并发症发生,然后随访有3例复发,其中1例复发4次,最后手术证实为Meckle憩室所致。本组在诊治过程无死亡病例发生。结论早期使用整复仪空气灌肠有助于提高肠套叠的诊断和复位率。采用中压、脉冲、间歇手术按摩改良法室气灌肠灌肠复位是种安全和有效的治疗措施。

Application of modified air enema method for the diagnosis and treatment of intussuception in children(An analysis of 84 cases)

Objective To investigate the applied value of modified air enema for the diagnosis and treatment of intussuception in children.Methods From January 2000 to December 2006,84 cases with infantile intussuception used modified air enema for diagnosis and treatment were analyzed retrospectively.Results In this group,diagnosis of intussuception was confirmed in 84 cases and it was excluded as non-intussception in 24 cases.Confirmed diagnosis rate 100%.Suceessful reduction was in 79 cases,reduction rate was 94.28%.Unsuceessful reduction and received operative treatment were in 5 cases.And among them,3 cases was intestinal necrosis,1 case ileo-ileocolon type intussuception and 1 case Meckel's diverticulum.No complications were found during reduction and after reduction.In the follow-up peroid,recurrences of intussuception were found in 3 cases,And among then,1 case had recurrence for 4 times.Recurrence was caused by Meckel's diverticulum,which was confirmed by operation finally.No death was found in the course of diagrosis and treatmnent.Conclusion Early air enema with enema reduction instrument may contribute to inprove diagnosis and reduction rate of intussuception.Modified air enema reduction with moderate pressure,pulse and massage of intermitten maneuver are a safe and effective therapeutic meusure.