小儿肠套叠120例诊治剖析.docVIP

小儿肠套叠120例诊治剖析 　　【摘要】#8195;目的#8195;探讨小儿肠套叠发病原因、机理、误诊情况及诊治方法。方法#8195;对120例小儿肠套叠的临床资料进行回顾性分析, 比较观察治疗效果。结果#8195;原发性肠套叠116例, 其中肥胖患儿71例, 占59.2%；人工喂养62例, 占51.7%；误诊16例, 占13.3%；手法复位86例, 复位率为 71.7 %。手术复位34例。继发性肠套叠4例, 均由肠道器质性病变引起。结论#8195;小儿原发性肠套叠的发生与喂养、肥胖及病毒感染有关。有些肠套叠患儿症状并不典型, 易误诊误治, 可结合B超及空气灌肠等检查综合判断。非手术治疗小儿肠套叠具有痛苦少、住院时间短等特点。 　　【关键词】#8195;儿童；肠套叠；诊断；治疗 　　 　　Clinical effect analysis of 120 cases of pediatric intussusception Gao Jian-peng. Health Center of Qingyun Town, Linyi 276712, China 　　【Abstract】ObjectiveTo investigate the etiology, mechanism, misdiagnosis and treatment methods of pediatric intussusception. MethodsAnalyzed clinical data of 120 cases of pediatric intussusception, then compared and observed the therapeutic effect. ResultsThere were 116 cases of primary intussusception, out of which, 71 cases of obesity children(59.2%); 62 cases of artificial feeding(51.7%); 16 cases of misdiagnosed(13.3%), 86 cases of manual reduction(71.7%). 34 cases of surgical reduction. 4cases of secondary intussusception, caused by intestinal organic disease. ConclusionThe incidence of primary intussusception in children is relate to feeding, obesity and viral infection. Some children with intussusception, their symptoms are not typical which is easy to diagnose, we can make our comprehensive judgment with ultrasound and air enema examination. Nonsurgical treatment of pediatric intussusception has many characteristics, such as less pain, shorter hospitalization time, and so on. 　　【Key words】Children; Intussusception; Diagnosed; Treatment肠套叠(intussusception)是指某段肠管及其相应的肠系膜套入邻近肠腔内引起的肠梗阻, 是婴儿期最常见的急腹症。好发于6~12个月的婴儿。2岁以后该病发病率明显降低, 且随着年龄的增长越来越少, 男孩发病是女孩的2倍。大多数套叠原因不明；少数因肠管发育畸形, 如美克尔憩室、游动盲肠而致发病。其临床进展急骤, 病情变化快。且小儿肠道发育不完善, 在日常的喂养过程中由于添加辅食不当、肠管蠕动紊乱、肠痉挛及病毒感染等原因造成肠套叠。绝大多数患儿不能用语言表达病史及腹痛特点, 且查体难以合作, 如稍有疏忽, 就可能会发生误诊。本院自2005年10月~2013年10月共收治急性肠套叠120例, 疗效良好, 现分析总结如下。 　　1资料与方法 　　1. 1一般资料120例中, 男72例, 女48例, 年龄1个月~13岁, 其中年龄1~6个月者39例, 7个月~2岁者78例, 3~13岁者3例。单纯肠套叠108例, 套叠合并肠坏死者12例。病程≤12 h的40例, 12~48 h的52例,