超声引导下生理盐水灌肠复位治疗小儿肠套叠的临床价值研究

Clinical value of ultrasound-guided normal saline enema reduction in treatment of children with intussusception

目的:探讨超声引导下生理盐水灌肠治疗小儿肠套叠的临床疗效及价值。方法:将我院收治的124例肠套叠患儿按照随机数字表法分为超声组和X线组各62例,超声组采用超声引导下生理盐水灌肠治疗,X线组采用X射线引导下行空气灌肠治疗,比较两组患儿的治疗效果。结果:超声组复位成功率为93.55%,X线组复位成功率为88.71%,两组之间差异没有统计学意义(P>0.05);超声组(67.42%)复位用时<30 min的患儿比例明显高于X线组(27.27%),超声组(1.72%)复位用时为60~90 min的患儿比例明显低于X线组(9.09%),超声组(25.68%)复位用时间为30~60 min的患儿比例与X线组(41.82%)组没有差异,超声组(1.72%)复位用时间为>90 min的患儿比例与X线组(9.09%)没有差异。超声组复位时间少于X线组,差异具有统计学意义(Z=-4.49,P<0.01)。两组患儿复位后复发率比较,超声组(6.90%)明显低于X线组(27.27%),差异具有统计学意义(χ~2=8.38,P<0.05)。结论:超声引导下生理盐水灌肠治疗小儿肠套叠不仅具有较高的复位成功率,且具有耗时少、无放射损害、复发率低的优点,同时还能为临床提供更多的治疗依据。

Objective： To investigate the clinical effect and value of ultrasound-guided pressure enema with normal saline in the treatment of children with intussusception. Methods： A total of 124 children with intussuscep-tion who were admitted to our hospital were divided into ultrasound group and X-ray group using a random numbertable, with 62 children in each group. The children in the ultrasound group were treated with ultrasound-guided nor-mal saline enema, and those in the X-ray group were treated with X-ray-guided air enema. Therapeutic outcomewas compared between the two groups. Results： There was no significant difference in the success rate of reductionbetween the ultrasound group and the X-ray group（93.55% vs 88.71%, P〉0.05）. Compared with the X-ray group,the ultrasound group had a significantly higher proportion of children with a reduction time of 〈30 minutes（67.42%vs 27.27%） and a significantly lower proportion of children with a reduction time of 60 ~ 90 minutes（1.72% vs9.09%）;there was no significant difference between the ultrasound group and the X-ray group in the proportion ofchildren with a reduction time of 30-60 minutes（25.68% vs 41.82%） or 〉90 minutes（1.72% vs 9.09%）. The ultra-sound group had a significantly shorter reduction time than the X-ray group（Z =-4.49, P〈0.01）. The ultrasoundgroup had a significantly lower recurrence rate after reduction than the X-ray group（6.90% vs 27.27%, χ^2= 8.38,P〈0.05）. Conclusion： Ultrasound-guided normal saline enema has the advantages of high success rate of reduc-tion, short reduction time, no radiation damage, and low recurrence rate in the treatment of children with intussusception. In addition, it can provide more therapeutic bases for clinical treatment.