成人肠套叠的诊断和治疗

Diagnosis and treatment of intussusception in adults

目的 探讨成人肠套叠的临床特点及误诊原因,提高诊断和治疗水平。方法 回顾性分析21例成人肠套叠的临床资料。结果 本组病例临床表现有腹痛、呕吐、腹胀、腹块、腹泻、便血。术前确诊6例,误诊15例。本组根据病因、病变部位、受累肠管的范围和程度均行相应的手术治疗。随诊6个月～2年,无肠套叠复发病例。结论 成人肠套叠的临床表现缺乏特异性,术前早期诊断较为困难。详细询问病史,体检、X线钡餐检查、B超及CT检查联合应用可提高肠套叠早期确诊率,及时手术可有效治疗成人肠套叠。

Objective To study the clinical characteristics and misdiagnostic causes of intussusception in adults,so as to improve the diagnosis and treatment.Methods The clinical data of 21 patients with intussusception in adults were analysed retrospectively. Results The clinical manifestations included abdominalgia, vomiting, abdominal distension and mass, diarrhea, hematochezia. The diagnosis was made preoperatively in 6 cases, and misdiagnosed in the other 15 cases. All patients underwent surgical operation accounting to cause,etiopathology and lesion. All patients were followed up for 6 months to 2 years, no one had intussusception reccurrence. Conclusion Because clinical manifestation of intussusception in adults is lacking in clinical characteristics, the early diagnosis of intussusception in adults is difficult. Combined use of the history illness, physical examination, X - ray of barium, B - us and CT examination can apparently improve the accurate rate of the early diagnosis. The surgical operation in time is the effective way for treating intussusception in adults.