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小儿肠套叠的大型单中心治疗经验。

A large single-center experience in management of pediatric intussusception.

机构信息

Department of Paediatric Surgery, Bristol Royal Children's Hospital, Bristol, UK.

Department of Paediatric Surgery, Ain Shams University, Faculty of Medicine, Cairo, Egypt.

出版信息

Pediatr Int. 2023 Jan-Dec;65(1):e15495. doi: 10.1111/ped.15495.

Abstract

BACKGROUND

The objective of this study was to present the results of a comprehensive single-center study of the management and outcome of intussusception over a 10-year period and to review the recent literature.

METHODS

A retrospective analysis was carried out of all children less than 16 years old, admitted with intussusception to our tertiary center between January 2007 and December 2016. Air enema was attempted routinely, with primary surgery reserved for selected cases. If air enema failed, open surgery was performed. The data collected included age, enema reduction rate, need for laparotomy, detail of bowel resection, hospital stay, and complications noted.

RESULTS

One hundred and ninety-one children presented with intussusception, totaling 200 admissions. One hundred and seventy-four patients (87%) underwent air enema. There was a complete reduction in 66% of these cases and a perforation rate of 1.1%. Twenty-six patients (13%) underwent primary surgery. Of the 59 patients with incomplete enema reduction, 50.8% required bowel resection while 49.2% required only manual reduction. Bowel resection was necessitated in 26% of total admissions and 61.2% of those requiring surgery. Hospital stays ranged from 3-97 days (median 7 days). There were four complications (2%).

CONCLUSION

This comprehensive study reveals a higher rate of surgical intervention and bowel resection than was anticipated from selective series in published literature. Institutional variation in outcome is likely multifactorial but incomplete data make comparisons difficult.

摘要

背景

本研究旨在呈现一项为期 10 年的关于肠套叠诊治结果的综合性单中心研究结果,并对近期文献进行回顾。

方法

对 2007 年 1 月至 2016 年 12 月期间在我院接受治疗的所有年龄小于 16 岁的肠套叠患儿进行回顾性分析。所有患儿均行空气灌肠复位治疗,仅选择性手术治疗。如果空气灌肠复位失败,则行开腹手术。收集的数据包括年龄、灌肠复位率、是否需要开腹手术、肠切除的详细情况、住院时间和并发症等。

结果

191 例患儿共 200 例次因肠套叠入院,其中 174 例(87%)接受了空气灌肠复位治疗。其中 66%的患儿完全复位,穿孔率为 1.1%。26 例(13%)患儿行直接手术治疗。在 59 例灌肠复位不完全的患儿中,50.8%需要肠切除,49.2%仅需要手法复位。肠切除的总发生率为 26%,手术患儿的发生率为 61.2%。住院时间为 3-97 天(中位数为 7 天)。有 4 例(2%)患儿出现并发症。

结论

本研究为一项综合性研究,与文献中的选择性研究相比,手术干预和肠切除的比例较高。机构间结果的差异可能是多因素的,但由于数据不完整,比较困难。

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