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[儿童肠套叠——诊断与治疗指南]

[INTUSSUSCEPTION IN CHILDREN - GUIDELINES FOR DIAGNOSIS AND TREATMENT].

作者信息

Shavit Itai, Levy Nitai, Dreznik Yael, Cytter Kuint Ruth, Soudack Michalle

机构信息

Division of Pediatrics, Hadassah Medical Center, Jerusalem, Israel.

Pediatric Emergency Department, Rambam Medical Center, Haifa, Israel.

出版信息

Harefuah. 2024 Jul;163(7):462-467.

Abstract

Ileocolic intussusception is the most common cause of acute intestinal obstruction in infancy. Without rapid diagnosis and intervention, as well as collaboration among physicians from multiple disciplines, the patient's condition can deteriorate significantly, leading to ischemia and bowel necrosis. This position paper is the work of a committee of the Israel Pediatric Association, the Israel Pediatric Surgery Association, the Israel Radiological Association (Pediatric Imaging Section), and the Israel Association of Emergency Medicine (Pediatric Emergency Medicine Section) with the aim of establishing guidelines and thereby improving the treatment of children. The paper discusses the principles of clinical evaluation, sonographic diagnosis, non-surgical treatment by pneumatic (air enema) or hydrostatic (fluid enema) reduction, and the possible complications of this treatment. Other topics discussed in this paper include sedation to reduce the pain and distress associated with the reduction procedure, post-procedure monitoring, and surgical treatment principles in cases where pneumatic or hydrostatic reduction fails.

摘要

回结肠套叠是婴儿期急性肠梗阻最常见的病因。若不迅速诊断和干预,且缺乏多学科医生的协作,患者病情会显著恶化,导致肠缺血和坏死。本立场文件是由以色列儿科学会、以色列小儿外科学会、以色列放射学会(儿科影像科)以及以色列急诊医学协会(儿科急诊医学科)组成的委员会的工作成果,旨在制定指南,从而改善儿童的治疗。该文件讨论了临床评估原则、超声诊断、通过气灌肠(空气灌肠)或水灌肠(液体灌肠)复位的非手术治疗方法以及这种治疗可能出现的并发症。本文还讨论了其他主题,包括减轻复位过程相关疼痛和痛苦的镇静措施、复位后的监测以及气灌肠或水灌肠复位失败时的手术治疗原则。

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