【作者】 唐郁宽； 许向东； 农绍汉； 邓炜； 陈汉威； 吕婉虹； 何俊诗；

【Author】 TANG Yu-kuan, XU Xiang-dong, NONG Shao-han, DENG Wei, CHEN Han-wei, LV Wan-hong, HE Jun-shi (Department of Radiology, People’s Hospital, Panyu District, Guangzhou 511400, China)

【机构】 广州市番禺区人民医院放射科； 广东省人民医院小儿科；

【摘要】 目的　探讨不同压力与不同加压方式空气灌肠对小儿难复性肠套叠的整复效果及安全性。方法　回顾性分析780例经空气灌肠整复的肠套叠患儿,先中低压复位,失败者再行高压整复,高压气压范围为14 .0～18.0kPa ,加压方式为遂级式(每次加压递增1kPa)或跳跃式加压(每次加压递增4～8kPa)。结果　中低压整复的780例中,遂级式和跳跃式加压复位成功率分别为5 1.5 2 %、71.11% ,两者间有非常显著性差异(P <0 .0 1)。在首轮复位失败的2 90例中,2 81例转用高压整复,遂级式和跳跃式加压复位成功率分别为5 3 .19%、96.15 % ,两者间亦有非常显著性差异(P <0 .0 1)。两种压力及两种加压方式空气灌肠的肠穿孔率无显著性差异(P >0 .0 5 )。结论　对于难复性或复杂型小儿肠套叠,若无肠坏死Χ线表现,可采用高压空气灌肠整复,其中跳跃式加压方式整复效果较遂级式更好更多还原

【Abstract】 Objective To study effectiveness and safety of air enema with different pressure and by different ways of pressurization in reduction of refractory intussusception in children. Methods 780 cases of pediatric intussusception given air enema were retrospectively reviewed. Air enema with medium and low pressure was first given. Air enema with high pressure was given to unsuccessful cases. High pressure ranged from 14.0 to 18.0 kPa. Pressurization adopted cascade methods (with 1 kPa being added each time) or jumping methods (with 4-8 kPa being added each time). Results Among the 780 cases adopted air enema with medium and low pressure, the success rates of cascade pressurization and jumping pressurization were 51.52% and 71.11% respectively. There was obvious difference between the two groups ( P <0.01). For the 290 cases failing first round of reduction operation, 281 cases adopted high-pressure restoration. The success rates of cascade pressurization and jumping pressurization were 53.19% and 96.15% respectively. There also existed obvious difference between the two groups ( P <0.01). There was no obvious difference between perforation rate of air enema with two kinds of pressure and the two methods of pressurization ( P >0.05). Conclusion For refractory or complicated intussusception, high-pressure restoration may be adopted in case there is no X-ray indication of bowel necrosis. Jumping pressurization may achieve better restoration effects than cascade pressurization.更多还原