Younes Alaa, Lee Sanghoon, Lee Jong-In, Seo Jeong-Meen, Jung Soo-Min
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06354, Korea.
Department of Surgery, CHA Medical Center, CHA University School of Medicine, Seongnam 13496, Korea.
Children (Basel). 2021 Feb 12;8(2):136. doi: 10.3390/children8020136.
Intussusception is one of the most common causes of intestinal obstruction in children. Pneumatic reduction is the treatment of choice and has a high success rate. The most common cause of pneumatic reduction failure is the presence of a pathological leading point. We aimed to identify other factors that can lead to pneumatic reduction failure in children with ileocolic intussusception. This was a retrospective study conducted in two centers. Data were collected from January 2013 to December 2014. A total of 156 patients were diagnosed with intussusception and underwent pneumatic reduction, with the exception of one patient with peritonitis. We included patients with ileocolic-type intussusception without apparent pathological leading points. Logistic regression analysis of clinical parameters was performed to identify factors associated with pneumatic reduction failure. Of 156 patients diagnosed with intussusception in both hospitals, 145 were enrolled in the study. The overall efficacy of pneumatic reduction was 85.7%, and surgical reduction was performed in 21 patients. Univariate analysis showed that a high segmented neutrophil count, low hemoglobin level, high body temperature, and higher weight percentile were associated with pneumatic reduction failure. Multivariate analysis showed that a high segmented neutrophil count, low hemoglobin level, and higher weight percentile were significantly associated with pneumatic reduction failure. Pneumatic reduction is safe and effective as a first-line treatment for pediatric intussusception. However, a high segmented neutrophil count, low hemoglobin level, and higher weight percentile are associated with the failure of this treatment.
肠套叠是儿童肠梗阻最常见的病因之一。空气灌肠复位是首选治疗方法,成功率较高。空气灌肠复位失败最常见的原因是存在病理性引导点。我们旨在确定其他可导致小儿回结肠型肠套叠空气灌肠复位失败的因素。这是一项在两个中心进行的回顾性研究。收集了2013年1月至2014年12月的数据。共有156例患者被诊断为肠套叠并接受了空气灌肠复位,其中1例腹膜炎患者除外。我们纳入了无明显病理性引导点的回结肠型肠套叠患者。对临床参数进行逻辑回归分析,以确定与空气灌肠复位失败相关的因素。两家医院共156例诊断为肠套叠的患者中,145例纳入研究。空气灌肠复位的总体有效率为85.7%,21例患者接受了手术复位。单因素分析显示,中性粒细胞分叶计数高、血红蛋白水平低、体温高和体重百分位数高与空气灌肠复位失败相关。多因素分析显示,中性粒细胞分叶计数高、血红蛋白水平低和体重百分位数高与空气灌肠复位失败显著相关。空气灌肠复位作为小儿肠套叠的一线治疗方法是安全有效的。然而,中性粒细胞分叶计数高、血红蛋白水平低和体重百分位数高与该治疗失败相关。