小儿肠套叠空气整复与肠壁肿胀关系的研究

The clinical research of the relation between air-pressure enema and the bowel swelling in infantile intussusception

目的探讨小儿肠套叠空气整复与肠壁肿胀厚度之间的关系。方法对61例肠套叠经彩色多普勒 B 超检查,测量套叠肠壁肿胀的厚度并记录,然后根据测量数据,按肠壁肿胀厚度,选择不同的空气压力进行整复。结果整复成功52例,占85%;失败9例,占15%。肠套叠空气整复成功与否与患儿的性别及肠套叠部位无明显关系,与肿胀肠壁厚度、空气压力有关。空气整复可行性的标准:当水肿肠壁厚度<1.1cm、选择空气压力8～15kPa,可以空气整复;当水肿肠壁厚度在1.1～1.5cm、选择空气压力8～13kPa,可.以谨慎地进行空气整复;当水肿肠壁厚度>1.5cm、空气压力不超过8kPa,只作诊断,不宜进行空气整复,否则有穿孔的危险。结论小儿肠套叠空气整复成功与否,与肠壁肿胀厚度有明显关系,这对小儿肠套叠选择性地空气整复具有很高的指导价值。

Objective To explore the relation of air enema with bowel swelling in＇infantile intussusception. Methods In 61 cases of infantile intussusception, the thickness of the swollen bowel wall was measured and recorded by color Doppler. Then different air pressure was used for enema according to the thickness of the swollen bowel wall. Results There were 52 （85%） cases succeeded in the operations, with 9 cases （15%） failed. Thus the standard of feasibility of air-pressure enema in infantile intussusception was as following： （1） When the thickness of the dropsical bowel wall 〈1.1cm, 8-15 kPa air-pressure could be used for air enema; （2） When the thickness of the dropsical bowel wall located in 1.1-1.5cm, 8-13 kPa air pressure, should cautiously be used for air enema; （3） When the thickness of the dropsical bowel wall 〉l.5cm, air pressure less than 8 kPa could be used only for diagnosis, not for therapy to prevent gastrointestinal perforation. Conclusion There is obvious relation between the succession of air-pressure enema with the dropsical degree of bowel wall in infantile intussusception. This standard has very high leading value for the selection of air-pressure enema in infantile intussusception.