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复发性肠套叠:水压灌肠的安全应用

Recurrent intussusception: safe use of hydrostatic enema.

作者信息

Fecteau A, Flageole H, Nguyen L T, Laberge J M, Shaw K S, Guttman F M

机构信息

Department of Pediatric General Surgery, Montreal Children's Hospital, McGill University, Quebec, Canada.

出版信息

J Pediatr Surg. 1996 Jun;31(6):859-61. doi: 10.1016/s0022-3468(96)90154-2.

Abstract

Recurrent intussusception (RI) occurs in 5% to 8% of patients with intussusception. The authors reviewed their 15-year experience to better define the management of RI. Among 258 patients, 28 (10.8%) had episodes of RI (37 episodes altogether). Twenty-two patients had a single recurrence, four had double recurrence, one had triple recurrence, and one had quadruple recurrence. RI and non-RI patients were compared with respect to symptoms. The incidence of vomiting and bloody stools was significantly lower in the RI group. Ten percent of RI patients had lead points. Thirty percent of RI episodes occurred within 24 hours, and 74% occurred within 6 months. The success rate of hydrostatic enema reduction for recurrent episodes was 62.8%, which is comparable to that for the initial episode (68.9%). Among patients with previous surgery, 36.3% of enemas were successful; after previous enema reduction, 75% were successful. There was no complication related to the enema. Enema reduction is safe and has a good success rate in cases of RI, even after previous surgical reduction.

摘要

复发性肠套叠(RI)发生于5%至8%的肠套叠患者中。作者回顾了他们15年的经验,以更好地明确RI的治疗方法。在258例患者中,28例(10.8%)有RI发作(共37次发作)。22例患者有单次复发,4例有两次复发,1例有三次复发,1例有四次复发。对RI患者和非RI患者的症状进行了比较。RI组呕吐和血便的发生率显著较低。10%的RI患者有肠套叠引导点。30%的RI发作发生在24小时内,74%发生在6个月内。复发性发作的水压灌肠复位成功率为62.8%,与首次发作的成功率(68.9%)相当。在既往接受过手术的患者中,36.3%的灌肠成功;在既往进行过灌肠复位后,75%成功。没有与灌肠相关的并发症。即使在既往手术复位后,灌肠复位在RI病例中也是安全的,且成功率较高。

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