小儿肠套叠的发病时间对空气灌肠整复成功率的影响

目的分析小儿肠套叠的发病时间长短对空气灌肠整复成功率的影响方法回顾2013年1月至2016g3月331例经空气灌肠整复治疗肠套叠患儿的临床资料，分析其发病时间及空气灌肠整复效果结果本组患儿发病时间1-65h，平均l5．6h主要临床症状包括阵发性腹痛、呕吐、血便、腹部包块空气灌肠整复成功302例（1-12h141例，13-24 h 127例．25-48h 27例，〉48h7倒），失败29例（1-12 h13例．13-24h12例，25-48h3例，〉48h1例），所有患儿均未出现肠穿孔等严重并发症39倒患儿首；欠经空气整复成功后不同时间复发，其中69．2％发生在首次治疗后48h内。结论小儿肠套叠经评估在表出现严重并发症的情况下，无论发病时间长短，均应首选空气灌肠作为非手术治疗，且对其治疗成功率无明显影响。

Objective To analyze whether the onset time influences the outcome of pneumatic reduction in children with intussusception. Methods The medical records of 331 consecutive children with intussusception between January 2013 and March 2016, who underwent air enema reduction regardless of the onset time were reviewed. Results The onset time ranged from 1 h to 65 h with median time of 15.6 h. The presenting clinical features including irritability/abdominal pain, vomiting, bleeding per rectum and palpable abdominal mass. Air enema reduction was successful in 302 of the 331 patients （ -12h 141, -24h 127, -48h 27, 〉48h 7 ） . In 29 patients, air enema failed to reduce the intussusception （ -12h 13, -24h 12, -48h 3, 〉48h 1 ） and none of these patients had colonic perforation during the procedure. 39 patients developed recurrence after successful pneumatic reduction of intussusception, with 69.2% presented within 48 h of the initial procedure. Conclusion Our data suggests that pneumatic reduction should be the first-line treatment in all children with intussusception regardless of onset time, except those with serious complications.And it also do not influence the outcome of pneumatic reduction.