儿童与成人肠套叠的比较

A comparative study on the differences between pediatric and adult intussusception

目的分析儿童和成人肠套叠在临床表现、诊断和治疗上的不同之处。方法对10年内收治的45例肠套叠的症状、诊断、套叠部位、病理和治疗方法进行回顾性分析。结果儿童组35例,成人组10例。儿童组以血便、呕吐为主要症状,而成人组腹痛最常见。相当多儿童肠套叠通过病史和体检得以诊断,而成人肠套叠诊断多依赖影像学技术。儿童组术前确诊率高。成人肠套叠常与基础病理因素有关,均手术治疗,而儿童组可经气钡灌肠复位治疗或手术。结论肠套叠在所有年龄段均可发生,但儿童与成人肠套叠在临床表现、诊断方法和治疗上有很多不同。这两个年龄组的肠套叠本质上有显著性差异,临床上必须区别处理。

Objective To explore the differences in the clinical presentation,diagnostic approach,and management between pediatric and adult intussusception.Methods The records of 45 patients during 10 years were reviewed retrospectively.The symptoms,diagnosis,sites of intussusception,associated pathologies,and treatment methods of each patient were analyzed.Results Thirty-five pediatric and 10 adult patients were included in the study.In the pediatric group,bloody stool and vomiting were the most common symptoms whereas adult patients commonly presented with abdominal pain.The present history and physical examination was diagnostic in a remarkable proportion of the pediatric patients,but the diagnosis was suggested based on imaging techniques in the adults,and preoperative diagnosis was more successful in the pediatric group.Intussusception was more often associated with an underlying pathology in adults and no adult patient underwent nonoperative reduction,whereas pediatric patients were managed either with hydrostatic reduction or surgery.Conclusion Although intussusceptions occur at all ages,there are major differences in the clinical presentation,diagnostic approach,and management between pediatric and adult populations.Intussusception is remarkably different in these two age groups and it must be approached from a different clinical perspective.