Wang Zhe, He Qiu-ming, Zhang Hong, Zhong Wei, Xiao Wei-qiang, Lu Lian-wei, Yu Jia-kang, Xia Hui-min
Guangzhou Women and Children's Medical Center, Guangzhou, People's Republic of China,
Pediatr Surg Int. 2015 Sep;31(9):855-8. doi: 10.1007/s00383-015-3726-8. Epub 2015 Jul 14.
To identify age risk factors of early recurrent intussusception after pneumatic enema reduction. Management opinions are proposed.
Two thousand two hundred and ninety-five intussusception patients' medical records from January 2009 to December 2011 were retrospectively reviewed and analyzed.
Of the 2295 patients, the intussusception of 1917 of them was initially reduced by pneumatic enema, with 127 cases recurring within 72 h. The early recurrence rate is 6.62%. The early recurrence rate of patients younger than 1 year old is 2.1% (22/1032), while the rate for those older than 1 year is 11.9% (105/885). The difference is significant (P = 0.0001). There were no significant differences between age groups older than 1 year. One hundred and seventeen cases of recurrence happened within 48 h, which accounted for 92.1% of all early recurrence. Recurrence patients were treated again with pneumatic enema, with a successful reduction in 93.7%. They were followed up for 2-4 years; the long-term recurrent rate was 11.8% (14/119). No patient had poor prognosis because of delayed treatment.
Intussusception patients older than 1 year tend to have greater early recurrence rate after pneumatic enema reduction; 92.1% of the early recurrent cases happened in 48 h. There is no need to hospitalize patients after pneumatic enema reduction. A repeat pneumatic enema is a good choice before surgical approach.
确定空气灌肠复位后早期复发性肠套叠的年龄危险因素,并提出处理意见。
回顾性分析2009年1月至2011年12月2295例肠套叠患者的病历资料。
2295例患者中,1917例肠套叠最初采用空气灌肠复位,其中127例在72小时内复发。早期复发率为6.62%。1岁以下患者的早期复发率为2.1%(22/1032),而1岁以上患者的复发率为11.9%(105/885)。差异有统计学意义(P = 0.0001)。1岁以上各年龄组之间无显著差异。117例复发发生在48小时内,占所有早期复发的92.1%。复发患者再次接受空气灌肠治疗,复位成功率为93.7%。对其进行2至4年的随访;长期复发率为11.8%(14/119)。无患者因治疗延迟而预后不良。
1岁以上肠套叠患者空气灌肠复位后早期复发率较高;92.1%的早期复发病例发生在48小时内。空气灌肠复位后无需住院。在手术治疗前,再次空气灌肠是一个不错的选择。