小儿肠套叠诊疗体会.docVIP

小儿肠套叠诊疗体会 　　[摘要] 目的 探讨小儿肠套叠诊疗过程中一些容易忽视的操作细节及其可能导致的后果,以减少并发症的发生。方法 随机抽取1998年9月~2009年7月我院120例小儿肠套叠病例,做回顾性分析,所有病例均采用X线透视下钡剂灌肠造影。结果 11例患儿造影术中未能复位,采取手术治疗,5例患儿复位后再次复套(其中4例钡灌肠后再次复位,1例采取手术复位、固定),32例患儿术后有腹泻或伴发热症状,28例球囊插管的囊壁染有少许鲜血,44例患儿造影术中球囊导管脱出,复位失败,再次做钡灌肠造影复位。结论 钡灌肠造影可清晰显示肠套叠部位,并于造影术中行治疗复位,可使患儿免受外科手术打击,如果不注意一些诊疗细节,可致一些不必要的并发症发生,增加患儿痛苦。 　　[关键词] 肠套叠复位; 灌肠; 透视 　　[中图分类号] R574.3 [文献标识码] A [文章编号] 1673-9701(2010)01-65-02 　　 　　Diagnosis and Treatment of Pediatric Intussusceptions 　　LEI Wenting GUO Nailiang YIN Jun 　　Xinyang Municipal Central Hospital,Xinyang 464000,China 　　 　　[Abstract] ObjectiveTo explore some of the operational details easy to be overlooked and its possible consequences in the diagnosis and treatment of pediatric intussusception in an attempt to reduce the incidence of complications. MethodsWe randomly selected 120 cases of children intussusception diagnosed in our hospital from Sep.1998 to July 2009 and made a retrospective analysis by using X-ray contrast barium enema. ResultsThe failed reduction of intussusception and re-surgery occurred for 11 cases,the re-intussusception occurred in 5 cases(re-reduction for four cases by barium enema and surgery reduction and fixation for one case),diarrhea or fever after operation in 32 cases,some fresh blood stained on the cystic walls of balloon catheter in 28 cases,and the barium enema reduction once more due to the prolapsed balloon catheter and failed reduction in 44 cases. ConclusionContrast barium enema can clearly show the intussusception position and the reduction by intraoperative angiography enables intussusception children to avoid sufferings from surgery. A number of unnecessary complications will happen if you neglect some details in the diagnosis and treatment of intussusception,increasing the children sufferings. 　　[Key words]Intussusception; Enema; Perspective 　　 　　肠套叠是小儿常见???,多发病,但是小儿肠套叠诊疗过程中一些容易忽视的操作细节往往可能导致严重后果,造成不必要的并发症,本文回顾性分析1998年9月~ 2009年7月我院120例小儿肠套叠病例,本组资料均采用X线透视下钡剂灌肠造影法,结果表明,钡灌肠造影可清晰