小儿过敏性紫癜并发急性肠套叠的诊治体会

The experience of treatment and diagnosis for acute intussusceptions in children with allergic purpura

目的：探讨小儿过敏性紫癜并发急性肠套叠的诊断策略和治疗原则。方法回顾性分析17例小儿过敏性紫癜并发急性肠套叠患儿的临床资料，包括临床表现、辅助检查、治疗方法及治疗效果。结果1例在 X 线下空气灌肠复位成功，16例手术病例均顺利完成手术。无严重并发症，无肠套叠复发病例。结论小儿过敏性紫癜并发的急性肠套叠以小肠套叠为主，早期诊断困难，易出现小肠坏死及穿孔。详细的病史采集结合 B 超等辅助检查对于早期诊断小儿过敏性紫癜并发急性肠套叠至关重要，积极手术探查有利于明确诊断并给予及时处理。

Objetive To explore the principle of treatment and diagnosis for acute intussusceptions in children with allergic purpura.Methods Retrospective analysis was given to the clinical data（clinical symp-toms,auxiliary examination,surgical procedures and the results）in 17 pediatric patients with known cases of allergic purpura who were treated for acute intussusceptions.Results Successful air insufflation reduction un-der X-ray was achieved in only 1 case.16 cases required surgical intervention without major complication.No recurrent case was registered. Conclusions Most of acute intussusceptions in children with allergic purpura were located in the small intestinal.Ultrasonography examination with detailed history collection is very impor-tant for early diagnosis of intussusceptions.Unfortunately the diagnosis was confirmed too late with 88% （14） of the patients ended with either intestinal necrosis or perforation.Active operative exploration is likely the most helpful to diagnose and to treat intussusceptions.