小儿原发性肠套叠的诊断与治疗

目的:探讨小儿原发性肠套叠的诊断和治疗。方法:回顾性分析我们自2004年8月—2009年8月来收治的326例临床病历资料,326例中321例B超初步诊断,5例B超未诊断但临床怀疑采用空气灌肠诊断。300例在压力83~120mmHg下复位,7例中转手术。超过48h的1例用75mmHg复位成功;18例手术治疗。结果:301例复位成功,25例行开腹手术,均顺利恢复出院。结论:对于小儿原发性肠套叠,B超是非常有价值的辅助检查,X线和结肠造影是诊断肠套叠的金标准,空气灌肠复位是最简便有效的复位方法,对不适合空气灌肠复位和空气灌肠复位失败者应及时手术治疗。

Diagnosis and Treatment of Primary Intussusception in Infants and Children

Objective To evaluate the diagnosis and treatment of primary intussusception in infants and children. Methods A total of 326 cases of primary intussusception were reviewed, among them 321 cases were primarily diagnosed by ultrasonography, the other 5 not diagnosed by B-ultrasound, yet were suspected clinically, so later diagnosed definitely by air enema. Results Of them, in 300 cases reduction was successful under the pressure of 83-120 mmHg; 7 cases were transferred to be operated. There were 19 cases with clinical history over 48 hours, only one of them was successfully reduced by air enema with a pressure of 75 mmHg, and the other 18 cases were treated by surgery. Conclusion Ultrasonography is a valuable diagnostic method for primary intussusception in infants and children. Roentgenography of the colon with air enema is the gold standard of diagnosis for intussusception in children. Air enema reduction is a simple and effective therapy of reduction ; while prompt laparotomy should be done for those not indicated to air enema or those failed with air enema.