Nayak Debashish, Jagdish S
Pediatric Surgery Unit Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, 605 006 India.
Indian J Surg. 2008 Feb;70(1):8-13. doi: 10.1007/s12262-008-0002-3. Epub 2008 Mar 19.
Intussusception is a common cause of acute intestinal obstruction with potentially serious complications. The treatment of choice is an attempt at initial non-operative treatment.
The purpose of the study was to evaluate the efficacy of the technique of hydrostatic reduction of intussusception using saline enema and ultrasound being practiced in our institute; the secondary goal was to identify patient subset in which it is more successful.
The case records of all patients treated for intussusception in our institute from 1st January 2000 to 30th June 2007 were retrospectively analyzed to collect information. All patients with ultrasound diagnosed intussusception that were not having signs of shock or peritonitis were treated with normal saline enema under ultrasound guidance. Failure of three such attempts was an indication for operation.
We found that this technique is easy, safe and extremely effective in treating intussusception in children. The success rate was 81.37% (83 out of 102 cases) and mortality rate was 1.2%. Ileoileocolic type of intussusception failed enema reduction more often (statistically significant; P value = 0.0032) while older patients (statistically significant, P value = 0.001) had higher success rates with the technique. Patients who had colocolic type of intussusception (P value = 0.29) and patients who present early (P value = 0.262) appear to have higher success rates but this was not statistically significant.
肠套叠是急性肠梗阻的常见病因,可能引发严重并发症。首选治疗方法是尝试初始非手术治疗。
本研究旨在评估我院采用生理盐水灌肠及超声引导下肠套叠水压复位技术的疗效;次要目标是确定该技术更易成功的患者亚组。
回顾性分析我院2000年1月1日至2007年6月30日期间所有接受肠套叠治疗患者的病例记录以收集信息。所有经超声诊断为肠套叠且无休克或腹膜炎体征的患者在超声引导下用生理盐水灌肠治疗。三次此类尝试失败即需手术治疗。
我们发现该技术在治疗儿童肠套叠方面简便、安全且极为有效。成功率为81.37%(102例中的83例),死亡率为1.2%。回结型肠套叠灌肠复位失败的情况更常见(具有统计学意义;P值 = 0.0032),而年龄较大的患者(具有统计学意义,P值 = 0.001)采用该技术的成功率更高。患有结肠型肠套叠的患者(P值 = 0.29)以及就诊较早的患者(P值 = 0.262)似乎成功率较高,但无统计学意义。