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婴幼儿急性肠套叠:66例患者的5年研究

Acute intestinal intussusception of the infant and the child: A 5-year study of 66 cases.

作者信息

Sagna Aloise, Camara Souleymane, Ly Ssata, Fall Ibrahima

机构信息

Albert Royer Children's Hospital, Cheikh Anta Diop University, Dakar, Senegal.

Cheikh Anta Diop University, Dakar, Senegal.

出版信息

Afr J Paediatr Surg. 2018 Jul-Dec;15(3):138-141. doi: 10.4103/ajps.AJPS_127_15.

Abstract

BACKGROUND

Acute intestinal intussusception (AII) is defined as the telescoping of part of the intestine into the intestinal segment beneath it. The consequence is an obstruction and strangulation which can lead to necrosis of the intestinal tract that has telescoped. The aim of our work is, on the one hand, to assess our management style throughout analysis of clinical different aspects and on the other hand to set up a strategy for early diagnosis and treatment.

METHODS

It is a retrospective study over 5 years from 2010 to 2015 including infants and children who had been treated for AII in Albert Royer Children's Hospital. The following variables such as age, sex, past time before the surgical consultation, initial diagnosis, imaging data view, treatment technique and results were itemised to bear comparison. Sixty-six records were reviewed.

RESULTS

The mean age was 5.73 months with a range of 2 and 144 months. Boys constituted the majority of patients with a ratio of 2:1. Children were referred to us with the diagnosis of intestinal obstruction or gastroenteritis in 50% of cases. Past time average before consultation was 5.3 days with a range of 14 h and 30 days. Most of the patients underwent surgery within 48 h after the beginning of the clinical picture. An abdominal ultrasound scan confirmed the diagnosis of AII in 57 cases, whereas in 9 cases, it was normal or not contributive. Non-operative reduction by retrograde pneumatic pressure or barium enema represented 33.4% of patients against 56.6% for surgical treatment. We registered 5 deaths and 2 recurrences. AII remains the main cause of intestinal obstruction in infants.

CONCLUSION

Authors stressed on delay in diagnosis with the treatment consequences belonging to that status and put emphasis in the importance of close collaboration between paediatricians, surgeons and radiologist for early diagnosis and nonoperative systematic reduction.

摘要

背景

急性肠套叠(AII)是指一部分肠管套入其下方的肠段。其结果是梗阻和绞窄,可导致套入的肠道坏死。我们这项工作的目的,一方面是通过分析临床不同方面来评估我们的治疗方式,另一方面是制定早期诊断和治疗策略。

方法

这是一项对2010年至2015年5年间在阿尔贝·罗耶儿童医院接受AII治疗的婴幼儿和儿童进行的回顾性研究。对年龄、性别、手术咨询前的过往时间、初始诊断、影像资料视图、治疗技术和结果等变量进行了详细列举以便进行比较。共审查了66份记录。

结果

平均年龄为5.73个月,范围在2至144个月之间。男孩占患者大多数,比例为2:1。50%的病例中患儿被诊断为肠梗阻或肠胃炎后转诊至我们这里。咨询前的平均过往时间为5.3天,范围在14小时至30天之间。大多数患者在临床表现出现后48小时内接受了手术。腹部超声扫描在57例中确诊为AII,而在9例中结果正常或无诊断价值。逆行气压或钡剂灌肠非手术复位占患者的33.4%,手术治疗占56.6%。我们记录到5例死亡和2例复发。AII仍然是婴儿肠梗阻的主要原因。

结论

作者强调了诊断延迟及其带来的治疗后果,并强调了儿科医生、外科医生和放射科医生密切合作对于早期诊断和非手术系统复位的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1ab/7646681/bfe0144e8269/AJPS-15-138-g001.jpg

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