Saxena A K, Höllwarth M E
Department of Pediatric Surgery, Medical University of Graz, Austria.
Acta Paediatr. 2007 Aug;96(8):1199-202. doi: 10.1111/j.1651-2227.2007.00374.x. Epub 2007 Jun 21.
This study aims to compare management strategy and outcomes of paediatric ileocolic intussusceptions (ICI) versus small-bowel intussusceptions (SBI).
Hospital charts of patients with intussusceptions between January 1999 and June 2006 were reviewed retrospectively.
A total of 135 patients with the diagnosis of intussusceptions were found in the database. In 111 patients the diagnosis was confirmed using ultrasound. The median age of the patients was 2.25 years (range 9 weeks-10 years). ICI were documented in 83 patients (74.8%) and SBI in 28 (25.2%). Spontaneous reductions were observed in 11 of 83 (13.3%) ICI and 18 of 28 (64.3%) SBI. Pneumatic reductions were attempted and were successful in 61 of 67 (91%) ICI and 6 of 7 (85.7%) SBI. Surgery was performed in 11 of 83 (13.3%) ICI and 4 of 28 (14.3%) SBI; with 2 of 83 (2.4%) ICI and 3 of 28 (10.7%) SBI patients requiring bowel resections. The median age of patients requiring surgery was 9 months in ICI and 6 years in SBI.
There are differences in ICI and SBI with regard to spontaneous reductions, and bowel resection, and age with regard to surgery and bowel resection. The treatment efficacy depends on time of presentation, intussusception type, pathologic lead points, ultrasound/colour Doppler interpretation and expertise in reduction techniques.
本研究旨在比较小儿回结肠套叠（ICI）与小肠套叠（SBI）的治疗策略及治疗结果。
回顾性分析1999年1月至2006年6月期间套叠患者的医院病历。
数据库中共发现135例诊断为套叠的患者。111例患者通过超声确诊。患者的中位年龄为2.25岁（范围9周 - 10岁）。记录显示83例（74.8%）为ICI，28例（25.2%）为SBI。83例ICI中有11例（13.3%）出现自发复位，28例SBI中有18例（64.3%）出现自发复位。尝试进行空气灌肠复位，67例ICI中有61例（91%）成功，7例SBI中有6例（85.7%）成功。83例ICI中有11例（13.3%）接受手术，28例SBI中有4例（14.3%）接受手术；83例ICI中有2例（2.4%）、28例SBI中有3例（10.7%）患者需要进行肠切除。接受手术的ICI患者中位年龄为9个月，SBI患者为6岁。
ICI和SBI在自发复位、肠切除以及手术和肠切除相关的年龄方面存在差异。治疗效果取决于就诊时间、套叠类型、病理性引导点、超声/彩色多普勒解读以及复位技术的专业水平。
