小儿急性肠套10年回顾

发布时间：2018-05-11 07:35

本文选题：儿童 + 肠套叠　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的：探讨小儿急性肠套叠的临床诊治经验,以提高小儿肠套叠的诊治水平。方法：回顾性分析10年间广西医科大学第一附属医院小儿外科收治的382例小儿急性肠套叠的临床资料,分析其临床特点及诊疗情况。结果：2005年01月～2015年01月共收治的382例急性肠套叠,空气灌肠复位354例,成功259例(73.2%),14例复发(5.4%)。不同病程的空气灌肠复位成功率差异有统计学意义,发病时间越长复位成功率越低。手术治疗166例(43.5%),其中空气灌肠复位失败后行手术治疗95例,确诊后直接手术71例(18.6%),手术治疗后有2例复发(4.2%)。复发性肠套叠共16例,复发率为4.2%,发生36次肠套叠,共复发20次；空气灌肠治疗16例共20次,复位成功17次(85.0%),与空气灌肠治疗初次肠套叠的成功率比较差异无统计学意义(x2=0.044,P0.05)。结论：小儿急性肠套叠应早诊断、早治疗,空气灌肠是首选的治疗方法。随着病程延长,复位成功率下降。应灵活掌握灌肠治疗的适应症、禁忌症。复发性肠套叠与首发肠套叠的治疗原则基本一致。手术是晚期患儿和非手术疗法失败时的有效治疗方法。
[Abstract]:Objective: to explore the clinical experience in the diagnosis and treatment of acute intussusception in children and to improve the diagnosis and treatment of intussusception in children. Methods: the clinical data of 382 children with acute intussusception in the first affiliated Hospital of Guangxi Medical University during the past 10 years were analyzed retrospectively. Results: from January 2005 to January 2015, 382 cases of acute intussusception were treated and 354 cases were reduced by air enema. There was significant difference in the success rate of air enema reduction in different course, the longer the onset time, the lower the reduction success rate. Surgical treatment was performed in 166 cases (43.5%), of which 95 cases were treated by operation after air enema reduction failed, 71 cases were operated directly after diagnosis, and 2 cases recurred after operation. There were 16 cases of recurrent intussusception with a recurrence rate of 4.2 times, 36 intussusception and 20 relapses, and 16 cases were treated with air enema for 20 times, and 17 times were successfully reduced. There was no significant difference in the success rate between air enema and air enema in the treatment of primary intussusception. Conclusion: children with acute intussusception should be diagnosed and treated early. Air enema is the first choice of treatment. With the prolongation of the course of disease, the success rate of reduction decreased. The indication and contraindication of enema treatment should be grasped flexibly. The treatment principle of recurrent intussusception and first intussusception is basically the same. Surgery is an effective treatment for late stage children and failure of non-operative therapy.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R726.5

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