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印度奥里萨邦引入本土轮状病毒疫苗后儿童肠套叠:基于医院的监测研究。

Childhood Intussusception after Introduction of Indigenous Rotavirus Vaccine: Hospital-Based Surveillance Study from Odisha, India.

机构信息

Department of Pediatrics, SCB Medical College, Cuttack, Odisha, India.

Department of Pediatrics, Institute of Medical Sciences (IMS) and SUM Hospital, Bhubaneswar, Odisha, India.

出版信息

Indian J Pediatr. 2021 Mar;88(Suppl 1):112-117. doi: 10.1007/s12098-020-03627-y. Epub 2021 Feb 5.

Abstract

OBJECTIVE

To study the epidemiology of intussusception in children < 2 y of age, postintroduction of Rotavac® (an indigenous oral rotavirus vaccine).

METHODS

A multicenter hospital-based surveillance was conducted in Odisha from February 2016 to June 2019. The cases were diagnosed according to Brighton level-1 criteria. Data were collected regarding the time of onset, signs and symptoms, radiological diagnosis, management, complications, and outcome (discharged/died).

RESULTS

One hundred and twenty children < 2 y of age were enrolled. The median age was 7 mo (M:F ratio = 2:1). The most common clinical feature was abdominal distention and blood in stool. The most common method for treatment was hydrostatic/pneumatic reduction. Median time (days) between symptom onset and admission was 2. Median (IQR) duration (days) of hospitalization was 5. Most common location of intussusceptions was ileo-colic.

CONCLUSIONS

Hydrostatic/pneumatic reduction was possible in the majority presenting ≤ 48 h of symptom onset, and those presenting > 48 h mostly required surgical reduction. Intestinal resection was required in some cases presenting on day 5 of symptom onset. Majority of cases were managed by surgical reduction in Government facility.

摘要

目的

研究 Rotavac®(一种本土口服轮状病毒疫苗)问世后,<2 岁儿童肠套叠的流行病学。

方法

2016 年 2 月至 2019 年 6 月,在奥里萨邦开展了一项多中心医院为基础的监测。根据布莱顿一级标准诊断病例。收集发病时间、体征和症状、影像学诊断、治疗、并发症和结局(出院/死亡)的数据。

结果

共纳入 120 名<2 岁的儿童。中位年龄为 7 个月(男女比例为 2:1)。最常见的临床特征是腹胀和大便带血。最常见的治疗方法是水压/气动复位。症状出现至入院的中位时间(天)为 2 天。中位(IQR)住院时间(天)为 5 天。肠套叠最常见的部位是回结肠。

结论

对于症状出现≤48 小时的大多数患儿,可以进行水压/气动复位,而对于出现>48 小时的患儿,大多数需要手术复位。对于症状出现第 5 天的一些患儿,需要进行肠切除。大多数病例在政府机构通过手术复位治疗。

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