【摘要】 目的:探讨空气灌肠复位失败肠套叠X线诊断的影像学表现,为指导临床治疗提供参考。方法:以2017年1月-2018年1月我院收治82例小儿肠套叠患者为研究对象,全部患儿均于X线引导下进行空气灌肠,复位失败后改行手术治疗。观察患儿手术结果及复位失败肠套叠X线诊断的影像学表现。结果:82患儿经手术治疗症状均解除,手术成功率100%。肠套叠类型:回-结-结型47例,回-回-结型21例,回-结型6例,回-回型5例,回-回-结-结型3例,其中复杂型肠套叠构成比最高,占86.59%。X线下观察可见复位失败肠套叠套头呈不规则形状,套头较长,空气加压灌注时,套头推进缓慢,在各肠断有停顿,或不推进,停滞在回盲部,套头随灌注气压大小而呈弹簧状收缩,但多次加压灌注套头均不消失。结论:空气灌肠复位失败肠套叠X线表现具有一定特征性,对于复位失败的患者,临床应早期改行手术,以减少并发症,保证治疗安全。更多还原

【Abstract】 Objective: To investigate the imaging findings of intussusception X-ray diagnosis of air enema reduction failure and provide guidance for clinical treatment. Methods: From January 2017 to January 2018,82 patients with intussusception in our hospital were enrolled in the study. All patients underwent air enema under X-ray guidance. After failed to reset,they were treated with surgery. Then observed the surgical findings and the imaging findings of the failed intussusception X-ray diagnosis. Results: The symptoms of 82 children were relieved by surgery,and the success rate of surgery was 100%. Intussusception type: 47 cases of retro-junction-junction type,21 cases of retro-retro-junction type,6 cases of retro-responsive type,5 cases of retro-responsive type,3 cases of retro-retro-junction type,of which complex Type intussusception constitutes the highest ratio,accounting for 86. 59%. Observed under the X-ray,the failure of the intussusception showed an irregular shape,the head was longer,and when the air was pressurized and infused,the head pushed forward slowly,and there was a pause in each bowel,or did not advance,and stagnated in the ileocecal region.It was spring-like in size,but it did not disappear after multiple pressures. Conclusion: The intussusception X-ray findings of air enema reduction have certain characteristics. For patients with failed reposition,the clinic should be diverted to surgery early to reduce complications and ensure the safety of treatment.更多还原