儿童肠套叠超声下水灌肠复位术的有效性和安全性

The effectiveness and safety of ultrasound-guided hydrostatic reduction for pediatric acute intussusception

目的评价急性肠套叠儿童实施超声监测下水灌肠复位术的有效性和安全性。方法选取2017年9月至2020年7月深圳市儿童医院的1830例经超声诊断为肠套叠的患儿,采用肠套叠水灌肠方案,行水灌肠复位治疗,观察治疗效果和并发症及其声像图表现。结果1830例急性肠套叠患儿中原发性肠套叠1791例、继发性肠套叠39例。经水灌肠复位成功1780例(97.3%,1780/1830);肠复位失败50例(2.7%,50/1830),复位失败者中包括原发性肠套叠42例、继发性肠套叠8例,均随后转为手术开腹治疗。在灌水过程中3例(0.16%,3/1830)出现并发症,均为肠穿孔;无死亡病例。结论超声监测下水灌肠复位术治疗儿童急性肠套叠是一种有效、安全的方法,避免了儿童X线辐射,可作为儿童肠套叠非手术治疗优先选择的方法。

Objective To evaluate the effectiveness and safety of ultrasound-guided hydrostatic reduction for pediatric acute intussusception.Methods One thousand eight hundred and thirty patients with acute intussusception diagnosed by ultrasound in Shenzhen Children′s Hospital from September 2017 to July 2020 were treated with ultrasound-guided hydrostatic reduction method.The therapeutic effects,complications and ultrasonic features were observed.Results Among 1830 cases,1791 cases were diagnosed as primary intussusception,and 39 cases were secondary intussusception.The overall rate of successful ultrasound enema reduction were 1780/1830(93.7%)patients.All 50/1830(2.7%)patients underwent surgery after unsuccessful enema reduction,including 42 cases of primary intussusception,and 8 cases of secondary intussusception.The complication of intestinal perforation occurred in 3 cases(0.16%),and there were no deaths.Conclusions Ultrasound-guided enema reduction for pediatric acute intussusception is an effective and safe method without radiation exposure,and can be used as the preferred method for non-operative treatment of intussusception.