Justice Frances A, Auldist Alex W, Bines Julie E
Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Victoria, Australia.
J Gastroenterol Hepatol. 2006 May;21(5):842-6. doi: 10.1111/j.1440-1746.2005.04031.x.
The association of a rotavirus vaccine and intussusception has renewed interest in understanding the incidence, clinical presentation and outcome of intussusception.
A retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne over a 6.5-year period (1 January 1995-30 June 2001) was conducted using patients identified by a medical record database (ICD-9-CM code 560.0 1993-1997; ICD-10-CM code 56.1 1998-2001). Patient profile, clinical presentation, diagnosis methods, treatment and outcome were analyzed and compared to data previously reported on children with intussusception at the same hospital during 1962-1968.
The hospitalization rate for primary idiopathic intussusception increased marginally from 0.19 to 0.27 per 1000 live births during the period 1962-1968 to 1995-2001. Most patients (80%) were <12 months of age (median age 7 months, range 2-72 months). The combination of abdominal pain, lethargy and vomiting was reported in 78% of infants. Air enema confirmed the diagnosis of intussusception in 186 of 191 cases (97%) and air reduction was successful in most cases (82%). Factors associated with increased risk of intestinal resection included abdominal distension (32%), bowel obstruction on abdominal X-ray (27%) and hypovolemic shock (40%). No mortality was observed in the present study.
Over the past 40 years at Royal Children's Hospital, Melbourne the hospitalization rate due to primary idiopathic intussusception has marginally increased from 0.19 to 0.27 per 1000 live births. Diagnosis and treatment using air enema has been highly successful, resulting in a reduction in patients requiring surgery and reduced hospital stays.
轮状病毒疫苗与肠套叠之间的关联重新引发了人们对了解肠套叠的发病率、临床表现及转归的兴趣。
对墨尔本皇家儿童医院在6.5年期间（1995年1月1日至2001年6月30日）所有诊断为肠套叠的患者进行回顾性病历审查，通过病历数据库识别患者（1993 - 1997年国际疾病分类第九版临床修订本代码560.0；1998 - 2001年国际疾病分类第十版临床修订本代码56.1）。分析患者资料、临床表现、诊断方法、治疗及转归，并与该医院此前报道的1962 - 1968年期间肠套叠患儿的数据进行比较。
原发性特发性肠套叠的住院率从1962 - 1968年期间每1000例活产儿中的0.19例微升至1995 - 2001年期间的0.27例。大多数患者（80%）年龄小于12个月（中位年龄7个月，范围2 - 72个月）。78%的婴儿出现腹痛、嗜睡和呕吐三联征。空气灌肠确诊了191例中的186例（97%）肠套叠，且大多数病例（82%）空气整复成功。与肠切除风险增加相关的因素包括腹胀（32%）、腹部X线显示肠梗阻（27%）和低血容量性休克（40%）。本研究中未观察到死亡病例。
在过去40年里，墨尔本皇家儿童医院原发性特发性肠套叠的住院率从每1000例活产儿中的0.19例微升至0.27例。使用空气灌肠进行诊断和治疗非常成功，减少了需要手术的患者数量并缩短了住院时间。
