超声引导下水压灌肠复位小儿肠套叠复发的危险因素分析

Risk factors for recurrent intussusception in children after ultrasound-guided saline enema reduction

目的探讨超声引导下水压灌肠复位小儿肠套叠复发的相关因素。方法回顾性分析2018年2月到2023年2月在郑州大学第一附属医院接受超声引导下水压灌肠首次复位成功的355例肠套叠患儿的临床资料,根据是否复发分为两组,并进行多因素Logistic分析。结果355例肠套叠患儿首次水压灌肠复位成功后6个月内复发56例,复发率为15.8%。单因素分析结果表明,两组间年龄、既往肠套叠病史、呕吐、彩超检查示同心圆最大径、合并肠道器质性病变差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果表明,年龄、既往肠套叠病史、同心圆最大径、合并肠道器质性病变是小儿肠套叠水压复位后复发的独立危险因素。ROC曲线分析显示年龄和同心圆最大径的最佳临界值分别为2岁和33.5 mm。结论年龄≥2岁、既往肠套叠病史、同心圆最大径≥33.5 mm、合并肠道器质性病变是水压灌肠复位后小儿肠套叠复发的独立危险因素。

Objective To explore the risk factors for recurrence of intussusception in children after successful ultrasound-guided saline enema reduction.Methods The clinical and follow up data of 355 hospitalized children with intussusception at the First Affiliated Hospital of Zhengzhou University from Feb 2018 to Feb 2023 were reviewed.Patients were divided into two groups by recurrence develped and the differences were compared,Data with significant differences were incorporated into multi-factor logistic analysis.Results The overall recurrence rate was 15.8%(56/355).By univariate variable analysis model,there were statistically significant differences between the two groups in age,previous intussusception history,vomiting,maximum diameter of concentric circles shown by ultrasound,and concurrent bowel organic diseases(lead points)(all P<0.05).In multivariate Logistic regression model,age,previous intussusception history,maximum diameter of concentric circles,and lead points were independent risk factors for recurrent intussusception after saline enema.The optimal cut-off values for age and maximum diameter of concentric circles were 2 years and 33.5 mm,respectively,according to ROC curve analysis.Conclusion Age older than 2 years,previous intussusception history,maximum diameter of concentric circles longer than 33.5 mm,and lead points are independent risk factors for recurrence after saline enema.