婴儿肠套叠伴肠坏死的临床X线表现(附231例分析)

Clinical and roentgenological manifestation of intussusceptional necrotic bowel in infants (analysis of 231 cases)

目的提高对肠套叠伴坏死的临床Ｘ线表现的认识。方法搜集近２０年经气压灌肠证实肠套叠的患儿８５１９例，其中２３１例经手术证实伴有肠坏死。回顾分析肠套叠伴肠坏死的主要临床Ｘ线表现及手术所见。结果肠套叠伴肠坏死重要的临床Ｘ线表现是：（１）血便出现早、次数多、量多；（２）套叠头大、多呈分叶状，加压后动度差；（３）套鞘松弛；（４）年龄小于４个月。出现上述表现者肠坏死的可能性更大。结论通过临床及Ｘ线透视下气压灌肠检查可明确肠套叠是否伴肠坏死，从而正确选择治疗方法。

Objective To improve the knowledge about intussusception complicated with necrotic bowel. Methods Over the past 20 years, there were 8 519 cases of intussusception confirmed by air pressure enema. Among these, 231 cases had necrotic bowel evidenced by surgical treatment. The main features both clinical and radiologic in all 231 cases were reviewed and analysed. Results The most significant features of intussusception complicated with necrotic bowel were:(1)Blood stool appeared early, more frequent and massive. (2)A big leaf shaped invaginated head with weak motility on pressure. (3)A lax intussuscipiens. (4) Young infants less than 4 months of age. Conclusions Necrotic bowel complicating intussusception could be correctly diagnosed by careful clinical, roentgenologic and air pressure enema examinations.