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超声引导下水压灌肠复位的注射器技术

The Syringe Technique for Ultrasound-Guided Hydrostatic Intussusception Reduction.

作者信息

Rai Sandeep, DCunha Aureen Ruby, ShreeRaghu R M, DSouza Neevan

机构信息

Department of Paediatric Surgery, K.S. Hegde Medical Academy, NITTE University, Mangaluru, Karnataka, India.

Department of General Surgery, K.S. Hegde Medical Academy, NITTE University, Mangaluru, Karnataka, India.

出版信息

J Indian Assoc Pediatr Surg. 2022 May-Jun;27(3):329-332. doi: 10.4103/jiaps.JIAPS_55_21. Epub 2022 May 12.

Abstract

BACKGROUND

Ultrasound-guided hydrostatic reduction (UGHR) is a well accepted and widely used method of paediatric intussusception reduction, with the saline drip technique being the most commonly employed.

AIMS AND OBJECTIVES

In this study we aimed to assess the outcomes of a novel technique of UGHR.

MATERIALS AND METHODS

Data was obtained from a 15 year retrospective chart review of paediatric intussusceptions. Following resuscitation, UGHR was performed for uncomplicated intussusceptions using a 50cc syringe to infuse saline into the colon. It was performed in the ultrasound suite without sedation and time taken was monitored. A maximum of 3 attempts were done to achieve reduction.

RESULTS

UGHR was attempted in 66 of 93 intussusceptions. The commonest type of intussusception was ileo-colic(91%) and the commonest symptom was vomiting(70%). Surgery was performed only when there was shock, peritonitis or repeated failed reductions. The median time taken for reduction was 4.9 minutes. The overall success rate was 83% with 89% of these requiring only a single attempt. There were no deaths or procedure related complications.

CONCLUSIONS

The syringe technique for intussusception reduction is a safe, effective, and time-saving technique. Additionally, it offers the advantages of simplicity and rapidity of reduction and in experienced hands may not require pressure monitoring.

摘要

背景

超声引导下水压灌肠复位术(UGHR)是一种被广泛接受且常用的小儿肠套叠复位方法,其中盐水滴注技术最为常用。

目的

在本研究中,我们旨在评估一种新型UGHR技术的效果。

材料与方法

数据来自对小儿肠套叠的15年回顾性病历审查。复苏后,使用50毫升注射器向结肠内注入盐水,对无并发症的肠套叠进行UGHR。在超声检查室进行,无需镇静,并监测所用时间。最多尝试3次以实现复位。

结果

93例肠套叠中有66例尝试了UGHR。最常见的肠套叠类型是回结肠型(91%),最常见的症状是呕吐(70%)。仅在出现休克、腹膜炎或多次复位失败时才进行手术。复位的中位时间为4.�分钟。总体成功率为83%,其中89%仅需单次尝试。无死亡或与手术相关的并发症。

结论

注射器法肠套叠复位术是一种安全、有效且省时的技术。此外,它具有复位简单快速的优点,在经验丰富的操作者手中可能无需压力监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8015/9208691/deb5c48fdd5a/JIAPS-27-329-g001.jpg

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