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儿童肠套叠:9年回顾

Childhood intussusception: a 9-year review.

作者信息

Ugwu B T, Legbo J N, Dakum N K, Yiltok S J, Mbah N, Uba F A

机构信息

Department of Surgery, Jos University Teaching Hospital, Nigeria.

出版信息

Ann Trop Paediatr. 2000 Jun;20(2):131-5. doi: 10.1080/02724936.2000.11748122.

Abstract

Sixty-four consecutive cases of intussusception in 48 infants and 16 older children managed at Jos University Teaching Hospital between January 1990 and December 1998 are reviewed. The age range was between 3 months and 15 years (mean 2.2 years) and the male to female ratio was 3.6:1. The quartet of abdominal pain, bloody mucoid stools, abdominal mass and palpable rectal mass was present in 70% compared with the classical triad (abdominal pain, bloody mucoid stools and abdominal mass) which occurred in only 32%. All the children had surgery. In 26 (41%) of the children, no associated cause was found, in three polyps formed the lead point and in five children a buried appendicectomy stump formed the lead point. In 30 (47%) other children, mesenteric lymphadenopathy and inflamed Peyer's patches were noted. Ileo-colic intussusception occurred in 32 (50%) children. Manual reduction was successful in 67%. Bowel resection for gangrene, irreducibility and an iatrogenic colonic tear was done in 30% of patients. Two (3%) had spontaneous reductions. There were four deaths. The commonest complications were wound infection and adhesive intestinal obstruction.

摘要

对1990年1月至1998年12月期间在乔斯大学教学医院收治的48例婴儿和16例大龄儿童的64例连续性肠套叠病例进行了回顾。年龄范围在3个月至15岁之间(平均2.2岁),男女比例为3.6:1。70%的患儿出现腹痛、血性黏液便、腹部肿块和可触及的直肠肿块这一组症状,而仅有32%的患儿出现经典三联征(腹痛、血性黏液便和腹部肿块)。所有患儿均接受了手术。26例(41%)患儿未发现相关病因,3例患儿以息肉作为套叠起点,5例患儿以隐匿性阑尾切除残端作为套叠起点。在其他30例(47%)患儿中,发现有肠系膜淋巴结病和炎症性派伊尔结。32例(50%)患儿发生回结肠型肠套叠。67%的患儿手法复位成功。30%的患者因坏疽、无法复位和医源性结肠撕裂而行肠切除。2例(3%)患儿自行复位。有4例死亡。最常见的并发症是伤口感染和粘连性肠梗阻。

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