Mallicote Michael U, Isani Mubina A, Roberts Anne S, Jones Nicole E, Bowen-Jallow Kanika A, Burke Rita V, Stein James E, Gayer Christopher P
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Am J Surg. 2017 Dec;214(6):1203-1207. doi: 10.1016/j.amjsurg.2017.08.040. Epub 2017 Sep 20.
After radiologic reduction, patients with ileocolic intussusception are often admitted. We hypothesize that discharge of stable patients after 4 h of emergency department (ED) observation does not result in an increase of adverse outcomes.
We retrospectively reviewed pediatric patients with ileocolic intussusception between 2011 and 2016, managed with either 24-h inpatient or 4-h ED observation. Outcomes included length of stay, adverse outcomes, and total hospital charges.
Fifty-one patients were managed with ED observation and 79 with inpatient observation. Recurrence rates, time to recurrence, and adverse outcomes were similar in both protocols. Total recurrence rates for ED observation was 15% versus 14% for inpatient observation. ED observation reduced time in the hospital by 26.8 h (4.9 versus 31.7 h).
Discharging patients following uncomplicated hydrostatic reduction of ileocolic intussusception after a 4-h observation period does not result in an increase in adverse outcomes.
在进行放射学复位后，回结肠套叠患者通常会住院。我们假设，在急诊科（ED）观察4小时后，对病情稳定的患者进行出院处理不会导致不良后果增加。
我们回顾性分析了2011年至2016年间接受回结肠套叠治疗的儿科患者，这些患者分别接受了24小时住院观察或4小时ED观察。结果包括住院时间、不良后果和总住院费用。
51例患者接受了ED观察，79例接受了住院观察。两种方案的复发率、复发时间和不良后果相似。ED观察的总复发率为15%，住院观察为14%。ED观察使住院时间缩短了26.8小时（4.9小时对31.7小时）。
在4小时观察期后，对回结肠套叠进行无并发症的水压复位后出院的患者，不良后果不会增加。
