数字胃肠机下空气灌肠对婴幼儿肠套叠的诊断价值

Application of air enema under digital gastrointestinal machine for infants with intussusception

目的探讨数字胃肠机下对肠套叠婴幼儿进行空气灌肠的应用价值。方法选取2013年11月至2017年10月843例数字胃肠机下空气灌肠的婴幼儿,男563例,女280例,其中经超声诊断肠套叠762例,经临床诊断81例。对843例婴幼儿进行空气灌肠,观察其肠套叠征象。结果立位腹部透视未见气液平面605例,占71. 8%。未见肠套叠征象40例,占4. 7%。符合肠套叠表现803例,其中复位成功率86. 9%,套头位于乙状结肠、直肠复位成功率分别为2. 5%、0%。复位失败病例的最后套头形态呈团状充盈缺损影54例,占51. 4%。复套1次66例,占78. 6%,24 h内复套48例,占57. 1%。结论对于肠套叠或疑是肠套叠的患儿胃肠机下做空气灌肠意义重大。对婴幼儿行空气灌肠时不建议做立位腹部透视。套头部位越接近肠道远端、套头呈团状充盈缺损影复位成功率低,建议不要强行复位。肠套叠成功复位后24 h内要密切关注患儿情况,防止复套。

Objective To investigate application effect of air enema under digital gastrointestinal machine for infants with intussusception. Methods A total of 843 infants with digital gastrointestinal air enema from November 2013 to October 2017 were selected, including 563 males and 280 females. Among the 843 cases, 762 cases of intussusception were diagnosed by ultrasound, and 81 cases were diagnosed by clinical diagnosis. The air enema was performed in 843 children, and the signs of intussusception were observed. Results There were no gas and liquid level signs in 606 cases by X-ray on abdomen erect position, accounting for 71.7%. No intussusception signs in 40 cases, accounting for 4.7%. There were 803 cases of intussusception. The successful rate of reduction was 86. 9% , and the success rate of sigmoid colon and rectum reduction was 2.5% and 0% respectively. In the case of failed reduction, there were 54 cases of cluster head filling defect, accounting for 51.4%. There were 66 cases in 1 times, accounting for 78.6%, and 48 cases in 24 h, accounting for 57.1%. Conclusions For children with intussusception or suspected intussusception, air enema under the gastrointestinal machine is of great importance. Air enema is not recommended for infants and young children. The closer the sleeve part is to the distal part of the intestine, the smaller the sleeve head filling defect is, the lower the reduction rate is. We should pay close attention to the condition of the children within 24 h after successful reduction of intussusception and prevent the recurrence of intussusception.