小儿复发性肠套叠的临床分析

CLINICAL ANALYSIS OF RECURRENT INTUSSUSCEPTION IN CHILDREN

目的 探讨小儿复发性肠套叠的发病原因和治疗方法。方法 复习近 5年治疗小儿急性肠套叠 11例复发病例。 11例复发性肠套叠复发 17例次 ,首次套叠时肥胖患儿 9例 (81 9% ) ;1周内有腹泻病史者 5例 (45 5 % ) ,上呼吸道感染者 4例 (36 4 % )。结果 所有的复发性肠套叠均经灌肠复位成功。其中 1例套叠为美克尔憩室并溃疡出血 ,复位后行美克尔憩室切除术 ;另 1例为两次手术复位后复发并行空气灌肠复位成功。结论 小儿复发性肠套叠可能和病毒感染有关 ,并且通过灌肠复位的成功率高而没有并发症 ;手术治疗复发性肠套叠多因灌肠复位失败和套叠为器质性病变者。小儿急性肠套叠初次手术复位后很少有套叠再次发生。

Objective To explore the causes and treatment methods of recurrent intussusception (RI) in children. Methods \ 105 children with intussusception were treated over the past 5 years, 11 of 105 cases (10.5%) had showed RI.Five of 11 patients had suffered from diarrhea and four had suffered from flu within one week. There were 17 times recurrences in 11 cases. Results \ All patients of RI were reduced successfully by air enema and barium enema. Only one patient with RI was found to have lead points which was Meckel′s diverticulum. One of those recurrences after surgery treatment was reduced successfully by air enema. Conclusion \ Viral infection may be the cause of RI in children. It can be treated successfully by air or hydrostatic reduction without complications. Surgical reduction of RI may be reserved for cases of failure of hydrostatic reduction or existence of pathological lead point. RI seldom occurs in patients who underwent surgical reduction.