儿童肠套叠住院趋势分析

Epidemiological analysis of childhood intussusception

目的通过对临沂市6年中儿童肠套叠的发病趋势及复发特点分析，探讨当地儿童肠套叠的流行病学特点及复发规律，为预防儿童肠套叠的发生和对疾病的治疗决策提供参考依据。方法对2006～2011年入院的所有肠套叠患儿进行回顾性研究，对患儿的临床资料、治疗、初发和复发特点进行分析。结果6年来共收治1805例，其中男1282例，女523例，男：女=2．45：1。空气灌肠整复1451次，手术354次，整复成功率80．39％。其中133例复发181次，复发率10．03％，男99例，女34例，男：女=2．91：1。再次空气灌肠整复163次，整复成功率90.05％。初次发病后6个月内复发122次，占67．4％。3岁以下患儿占复发患儿的85．08％。2岁以下儿童肠套叠年平均发病率为222．50／10万。术中发现17例肠套叠由于继发因素引起，3岁以上有10例。结论空气灌肠是治疗儿童肠套叠的有效措施，也是治疗复发性肠套叠的有效手段。3岁以下儿童是防治肠套叠的重点人群，初次发病后6个月内是预防肠套叠复发的关键时期，3岁以上儿童应警惕继发性肠套叠的可能。回盲部解剖异常可能是导致肠套叠复发的主要原因。

Objective To study the epidemiology of childhood intussusception and characteristics of recurrence in Linyi city and to provide the basis for making plans for prevention and surveillance. Methods A retrospective review of all patients diagnosed with intussusception at Linyi Peoples Hospital, from January 2006 to December 2011 was carried out. We evaluated clinical data, treatment,presentation and recurrence characteristics. Results During the ＆year period, 1805 patients （1282 males, 523 females） with intussusception were treated in our hospital. The ratio of male to female patients was 2. 45 ： 1. Air enema reduction had a success rate of 80. 39%. There were 181 episodes of recurrent intusussception in 133 patients （99 males, 34 females）. The overall recurrence rate was 10. 03%. The ratio of male to female patients was 2. 91 ： 1. Repeated enema reduction had a success rate of 90. 05 %. 122 （67.4%） cases of recurrent intusussception occurred within 6 months. 85. 080//00 of all recurrent cases were younger than 3 years old. The average annual incidence rate of intussusception was 222. 50 per 100,000 children less than 2 years of age. Pathologic lead points were present in 17 cases, 10 cases were older than 3 years. Conclusions Air enema reduction is an effective treatment for children with primary and recurrent intussusceptions. The focus of surveillance should be in those who are under 3 years old and within six months of the initial episode. For those who are more than 3 years old, there is a high possibility of secondary intussusception due to anatomical anomalies.