影响小儿小肠型肠套叠自发复位的多因素分析

Analysis of Risk Factors Affecting the Spontaneous Reduction of Small Bowel Intussusception in Pediatric Patients

目的探讨影响小儿小肠型肠套叠自发复位的相关因素。方法回顾性分析潍坊市人民医院2013年1月至2015年12月收治的169例小肠型肠套叠患儿的临床资料,根据治疗方法的不同分为观察组和手术组,将可能影响小儿小肠型肠套叠自发复位的13项因素(性别、月龄、病程、发热、腹痛、呕吐、腹部包块、果酱样便、腹胀、腹腔积液、肠系膜淋巴结肿大、套叠直径、套叠长度)进行单因素分析和logistic多因素回归分析,判断预测因素是否与患儿小肠套叠的自发复位有关。结果单因素分析结果显示,病程、发热、腹部包块、果酱样便、腹胀、腹腔积液、肠系膜淋巴结肿大、套叠直径和套叠长度9项因素与小肠套叠能否自发复位密切相关;logistic多因素回归分析提示有6项因素可预测小肠套叠患儿是否需紧急手术,其作用强弱依次为果酱样便、套叠直径、腹部包块、病程、套叠长度、腹胀。结论小儿小肠型肠套叠大部分是暂时性的,具有自发复位的特点,果酱样便、套叠直径、腹部包块、病程、套叠长度、腹胀是患儿小肠套叠自发复位的主要危险因素。

Objective To evaluate the risk factors which affect the reduction of small bowel intussusception in pediatric patients.Methods 169 pediatric patients with small bowel intussusception treated from January of 2013 to December of 2015 were reviewed and divided into the observation group and the operation group according to the different treatment methods.Pearson single factor analysis and multivariate logistic regression analysis were adopted to analyze the 13 predicative factors of affecting the reduction of intussusception,which consisted of sex,age,duration of symptoms,fever,the abdominal pain,the vomiting,abdominal mass,bloody stool,abdominal distention,seroperitoneum,enlarged mesenteric lymph node,the diameter and length of intussusception.Results Pearson single factor analysis indicated that the spontaneous reduction of the small intestine was closely related to the 9 factors including course of disease,fever,abdominal mass, bloody stool,abdominal distention,seroperitoneum,Enlarged mesenteric lymph nodes,the diameter of intussusception,length of intussusception.Multivariate logistic regression analysis indicated that the important factors of small bowel intussusception reduction were bloody stool,the diameter of intussusception,abdominal mass,course of disease,length of intussusception,and course of disease,and they are the independent predictors of surgery.Conclusion Most of the small bowel intussusception is often temporary,and the main risk factors of spontaneous reduction of the small intestine consist of bloody stool,the diameter of intussusception,length of intussusception,abdominal mass,course of disease,and abdominal distention.