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尼日利亚一家三级医院小儿肠套叠的流行趋势。

Trends in childhood intussusception in a Nigerian tertiary hospital.

机构信息

Department of Pediatric Surgery, College of Medicine, University of Nigeria Teaching Hospital, Enugu.

Department of Surgery, Alex Ekwueme Federal University Teaching Hospital Abakaliki.

出版信息

Afr Health Sci. 2024 Mar;24(1):213-219. doi: 10.4314/ahs.v24i1.26.

Abstract

BACKGROUND

Early presentation, high rate of successful non-operative treatment, low morbidity and mortality in childhood intussusception is common in High and Upper Middle-Income Countries but not in many Lower middle- and Low-income countries.

AIM

To assess the trends in the profile, treatment modalities and outcomes of intussusception in our hospital.

MATERIALS AND METHODS

Retrospective study over a 12-year period divided into two 6-year periods. Data entry/analysis was done using SPSS and various indices were compared between these two periods. Two-tailed t-test for two independent means was used to compare means while two-tailed Fisher exact tests were used to compare categorical variables. Results were presented as tables, means, ranges, percentages and a p-value less than 0.05 was deemed statistically significant.

RESULTS

There was a significant increase in the proportion of successful non-operative treatment (18.6% vs 34%, p=0.03), reduction in the incidence of operative manual reduction (27.1% vs 12.8%; p=0.026), reduction in operative treatment (78.5% vs 63.9%, p=0.034), increased utilization of pre-intervention ultrasound (75% vs96.7%, p<0.0001) and reduction in hospital stay duration (10.47 ±7.95days vs 7.24±4.86 days; p=0.004).

CONCLUSIONS

Contribution of successful non-operative treatment to the overall treatment of intussusception significantly increased while that of operative manual reduction significantly reduced and bowel resection showed no change. Preoperative utilization of ultrasonography significantly increased while mean duration of admission reduced significantly, but late presentation, morbidity and mortality rates had no significant changes.

摘要

背景

在高收入和中上收入国家,儿童肠套叠的早期表现、高非手术治疗成功率、低发病率和死亡率较为常见,但在许多中低收入国家并非如此。

目的

评估我院肠套叠患者的特征、治疗方式和结局的变化趋势。

材料和方法

回顾性研究,研究时间为 12 年,分为两个 6 年时间段。使用 SPSS 进行数据录入/分析,比较两个时间段的各种指标。采用双尾 t 检验比较两组均值,采用双尾 Fisher 确切概率法比较分类变量。结果以表格、均值、范围、百分比表示,p 值<0.05 为有统计学意义。

结果

非手术治疗成功的比例显著增加(18.6%比 34%,p=0.03),手术手法复位的发生率降低(27.1%比 12.8%,p=0.026),手术治疗减少(78.5%比 63.9%,p=0.034),术前超声检查的使用率增加(75%比 96.7%,p<0.0001),住院时间缩短(10.47±7.95 天比 7.24±4.86 天,p=0.004)。

结论

非手术治疗在肠套叠总体治疗中的作用显著增加,而手术手法复位的作用显著降低,肠切除术无明显变化。术前超声检查的应用明显增加,住院时间明显缩短,但晚期就诊、发病率和死亡率无明显变化。

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