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儿童肠套叠复位成功率的比较:结肠镜检查与超声引导下盐水灌肠

Comparison of success rates in intussusception reduction in children: colonoscopy versus ultrasound-guided saline enema.

作者信息

Naghizadeh Reyhaneh, Davar Ahmad Ali, Teimouri Alireza, Khalili Manijeh, Zadehmir Mohadeseh

机构信息

Department of Radiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

2Children and Adolescents Health Research Center, Research Institute of Cellular and Molecular Science in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran.

出版信息

Gastroenterol Hepatol Bed Bench. 2025;18(2):196-204. doi: 10.22037/ghfbb.v18i2.3116.

Abstract

AIM

This study evaluated and compared the success rates of intussusception reduction in children younger under three years of age using colonoscopy versus ultrasound-guided saline enema.

BACKGROUND

Intussusception involves telescoping one segment of the intestine into another.

METHODS

This experimental study included 41 children under three years old who were diagnosed with intussusception via ultrasound and admitted for reduction treatment. Participants were randomly assigned to either the saline enema or colonoscopy intervention. Data analysis was conducted using Chi-square tests and independent T-tests, utilizing SPSS 23.

RESULTS

Among the 41 children, 16 underwent reduction via colonoscopy, achieving a success rate of 81.25% (13 out of 16). In contrast, the saline enema method demonstrated a success rate of 84% (21 out of 25). The difference in success rates between the two methods was not statistically significant. Factors such as gender, age, the location of intussusception (ileocolic vs. colocolic), and the size of the intussusception did not significantly influence the success rates for either approach. Notably, intra-abdominal free fluid was significantly associated with reduced success rates for the saline enema method (P = 0.044). At the same time, no such association was found for the colonoscopy method (P = 0.142). Additionally, the presence of lymphadenopathy between the invaginated segments significantly impacted the success of the saline enema method (P = 0.036) but did not affect colonoscopy outcomes (P = 0.375).

CONCLUSION

The study concluded that there was no significant difference in the success rates of intussusception reductions between the colonoscopy and saline enema methods. Lymph nodes between invaginated loops and intraperitoneal fluid significantly decrease the success rate of saline enema reductions, suggesting that colonoscopy may be preferable in such cases.

摘要

目的

本研究评估并比较了三岁以下儿童使用结肠镜检查与超声引导下盐水灌肠进行肠套叠复位的成功率。

背景

肠套叠是指一段肠管套入另一段肠管。

方法

本实验研究纳入了41名三岁以下经超声诊断为肠套叠并入院接受复位治疗的儿童。参与者被随机分配至盐水灌肠或结肠镜检查干预组。使用SPSS 23进行卡方检验和独立样本t检验进行数据分析。

结果

41名儿童中,16名接受了结肠镜检查复位,成功率为81.25%(16例中的13例)。相比之下,盐水灌肠法的成功率为84%(25例中的21例)。两种方法的成功率差异无统计学意义。性别、年龄、肠套叠部位(回结肠型与结肠结肠型)和肠套叠大小等因素对两种方法的成功率均无显著影响。值得注意的是,腹腔内游离液体与盐水灌肠法成功率降低显著相关(P = 0.044)。同时,结肠镜检查法未发现此类关联(P = 0.142)。此外,套叠段之间存在淋巴结肿大对盐水灌肠法的成功率有显著影响(P = 0.036),但不影响结肠镜检查结果(P = 0.375)。

结论

该研究得出结论,结肠镜检查和盐水灌肠法在肠套叠复位成功率上无显著差异。套叠环之间的淋巴结和腹腔内液体显著降低了盐水灌肠复位的成功率,表明在这种情况下结肠镜检查可能更可取。

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本文引用的文献

1
The Management of Intussusception: A Systematic Review.肠套叠的管理:一项系统评价。
Cureus. 2023 Nov 27;15(11):e49481. doi: 10.7759/cureus.49481. eCollection 2023 Nov.
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Practical Imaging Strategies for Intussusception in Children.小儿肠套叠的实用影像学策略。
AJR Am J Roentgenol. 2020 Dec;215(6):1449-1463. doi: 10.2214/AJR.19.22445. Epub 2020 Oct 21.
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Current Views in the Diagnosis and Treatment of Intestinal Intussusception.肠套叠诊断与治疗的当前观点
Top Companion Anim Med. 2019 Dec;37:100360. doi: 10.1016/j.tcam.2019.100360. Epub 2019 Sep 11.
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Corrigendum: Atropine Premedication Facilitates Ultrasound-Guided Reduction by Saline Enema in Children With Intussusception.
Front Pharmacol. 2019 Aug 2;10:862. doi: 10.3389/fphar.2019.00862. eCollection 2019.

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