O'Ryan Miguel, Lucero Yalda, Peña Alfredo, Valenzuela María Teresa
Microbiology Program, Instituto de Ciencias Biomédicas, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile.
Pediatr Infect Dis J. 2003 Aug;22(8):717-21. doi: 10.1097/01.inf.0000078374.82903.e8.
A need for updated information on different aspects of idiopathic intussusception resurged after the Rotashield experience. Variability of incidence rates worldwide and the possibility of a more severe outcome among infants that have intussusception at a younger age are two issues that remain unclear. We aimed to provide updated information on clinical aspects of intussusception in a large population of Chilean children <2 years of age, including a best estimate of incidence rate and a comparative analysis of the clinical evolution for children younger and older than 6 months of age.
Several sources of information were used to recollect all intussusception cases 0 to 24 months of age treated in six public pediatric hospitals of the Metropolitan area during years 2000 and 2001 and to obtain updated estimates of the population covered by these hospitals. A thorough chart review of intussusception cases was performed using a standardized case report form.
A total of 50 and 45 intussusception cases were detected for 2000 and 2001, respectively, and estimated intussusception rates for children 0 to 24 months and for the subgroup <12 months of age were 35 and 32 per 100 000, and 55 and 47 per 100 000. The monthly distribution of intussusception cases differed for both years without an identifiable reason, and no association between intussusception and rotavirus infection was observed. No intussusception-associated death was recorded. Overall complications occurred in 21% of children, and infants younger than 6 months of age did not have more complications or a more prolonged hospital stay than older children.
Idiopathic intussusception is not uncommon among Chilean infants with incidence rates similar to those reported in the United States. There was no clear association with preexisting rotavirus infection and occurrence of complications was not related to young age.
在轮状病毒疫苗(Rotashield)事件之后,对于特发性肠套叠不同方面最新信息的需求再次出现。全球发病率的差异以及年龄较小的婴儿发生肠套叠时可能出现更严重后果这两个问题仍不明确。我们旨在提供关于智利大量2岁以下儿童肠套叠临床情况的最新信息,包括发病率的最佳估计值,以及对6个月以下和6个月以上儿童临床病程的比较分析。
利用多种信息来源收集2000年和2001年在首都地区六家公立儿童医院接受治疗的所有0至24个月龄肠套叠病例,并获取这些医院所覆盖人群的最新估计值。使用标准化病例报告表对肠套叠病例进行全面的病历审查。
2000年和2001年分别共检测到50例和45例肠套叠病例,0至24个月龄儿童以及12个月以下亚组儿童的估计肠套叠发病率分别为每10万例35例和32例,以及每10万例55例和47例。这两年肠套叠病例的月度分布情况不同,原因不明,且未观察到肠套叠与轮状病毒感染之间存在关联。未记录到与肠套叠相关的死亡病例。总体并发症发生在21%的儿童中,6个月以下婴儿的并发症并不比年龄较大儿童更多,住院时间也没有更长。
特发性肠套叠在智利婴儿中并不罕见,发病率与美国报告的相似。与既往轮状病毒感染没有明确关联,并发症的发生与年龄小无关。