小儿肠套叠空气灌肠易整复超声征像及套叠类型临床应用研究

Clinical Application Study on Ultrasonic Images and Types of Child Intussusception Easily Taxised by Air Enema

目的进一步探讨小儿肠套叠空气灌肠易整复的类型和易整复的超声征象。方法收集行空气灌肠整复治疗的12岁以下肠套叠患儿95例,记录套头的位置等,观察套头有无一定的活动度,≥2cm为套头活动征阳性。套叠整复后,维持肠管内气压30mmHg,肌注山莨菪碱（0.2mg/kg）,1015min后排气、拔管。结果 95例中6例清洁灌肠后套叠已整复。余87例经空气灌肠套叠整复。其中6例回回型小肠肠套叠灌肠见气体通过回盲瓣迅速充盈六、五组小肠,平均用时11min;＂套头活动征＂阳性者平均用时18min;套头较固定者平均用时29min。2例空气灌肠未能整复,转手术治疗。结论回回型小肠套叠是空气灌肠易整复的肠套叠类型之一;＂套头活动征＂是肠套叠容易整复的重要的超声征象。

Objective To further investigate ultrasonic images and types of child intussusception easily taxised by air enema. Methods 95 intussusception patients who were less than 12 years old were collected. The locations and motion of cuff head were observed by routine perspective of abdomen. The cuff head-motion sign was defined as the distance which the cuff head was impelled in excess of 2cm. The air pressure of 30mmHg was maintained in intestinal canal for 10-15 minutes and anisodamine（0.2mg/ kg） was given by intramuscular injection after indigitation taxis. The air was evacuated and tube was pulled out. Results 6 cases were taxised after cleaning enema in 95 cases of intussusception. Other 87 cases were taxised by air enema. Gases passed through ileal valve, then entered and quickly filled in sixth and fifth groups of small intestine in 6 of 89 cases diagnosed ileum-ileum type intussusception, which the enema time was average 11 minutes. The enema time was average 18 minutes when the patients displayed the motion of cuff head, the average time was 29 minutes when cuff head was comparatively fixed. 2 cases were not taxised by air enema and treated by surgery. Conclusion Ileum-ileum type of intussusception was easily taxised by air enema. It was considerable ultrasonic sign of intussusception easily tasixed when the motion of cuff head was observed.