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婴幼儿复发性肠套叠的发生率:一项全国性再入院分析。

Incidence of recurrent intussusception in young children: A nationwide readmissions analysis.

机构信息

DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.

DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.

出版信息

J Pediatr Surg. 2020 Jun;55(6):1023-1025. doi: 10.1016/j.jpedsurg.2020.02.034. Epub 2020 Feb 27.

Abstract

BACKGROUND/PURPOSE: Recurrent intussusception following successful nonoperative reduction has previously been reported with a frequency of 8%-12% based on data from individual institutions. Meanwhile, the timing of discharge after successful reduction continues to be debated. Here, we evaluate readmissions for recurrent intussusception in young children using a large-scale national database.

METHODS

The National Readmissions Database (2010-2014) was queried to identify young children (age < 5 years) diagnosed with intussusception. We compared procedures performed during the index admission and frequency of readmissions for recurrent intussusception. Results were weighted for national estimates.

RESULTS

We identified 8289 children diagnosed with intussusception during an index admission. These patients received definitive treatment with nonoperative reduction alone (43%), surgical reduction (42%), or bowel resection (15%). Readmission for recurrent intussusception was required for 3.7% of patients managed with nonoperative reduction alone, 2.3% of patients that underwent surgical reduction, and 0% of those that underwent bowel resection. Median time to readmission was 4 days after nonoperative reduction, and only 1.5% of these patients experienced recurrence within 48 h of discharge.

CONCLUSIONS

Recurrent intussusception may be substantially less common than previously reported. Our findings support the practice of discharge shortly after successful nonoperative reduction.

TYPE OF STUDY

Retrospective, prognosis study.

LEVEL OF EVIDENCE

III.

摘要

背景/目的:基于个别机构的数据,先前报道的成功非手术复位后复发性肠套叠的频率为 8%-12%。同时,成功复位后出院的时间仍存在争议。在此,我们使用大型国家数据库评估幼儿复发性肠套叠的再入院情况。

方法

通过国家再入院数据库(2010-2014 年)查询确诊为肠套叠的幼儿(年龄<5 岁)。我们比较了索引入院期间进行的手术和复发性肠套叠的再入院频率。结果经过全国估计进行加权。

结果

我们在索引入院期间共确定了 8289 名患有肠套叠的儿童。这些患者接受了单纯非手术复位(43%)、手术复位(42%)或肠切除(15%)的确定性治疗。单纯非手术复位的患者中有 3.7%需要再次入院治疗复发性肠套叠,手术复位的患者中有 2.3%需要再次入院,而接受肠切除的患者中无一例需要再次入院。非手术复位后中位再入院时间为 4 天,其中只有 1.5%的患者在出院后 48 小时内复发。

结论

复发性肠套叠的发生率可能远低于先前报道的水平。我们的研究结果支持成功非手术复位后不久出院的做法。

研究类型

回顾性预后研究。

证据等级

III。

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