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目的探讨儿童急性肠套叠早期的临床特点和处理原则。方法:选择2010年6月至2012年4月泰安市中心医院收治的196例急性肠套叠患儿作为研究对象,对其临床特点、诊断方法、治疗方法及疾病预后等临床资料进行回顾性分析。结果:患儿年龄:小于4个月14例,4-10个月101例,11-24个月54例,24个月以上27例;144例(34.4%)患儿表现腹痛、呕吐、血便、腹部包块;50例(23.3%)仅有阵发性哭闹;25例(11.6%)仅有呕吐;24例(11.6%)仅有腹泻;7例(3.3%)仅有发热、哭闹;20例(9.3%)有呕吐、腹泻;15例(7.0%)有腹痛、呕吐、腹泻。早期行超声检查诊断肠套叠的符合率明显高于未行超声检查者(P<0.05)。196例肠套叠患儿行空气灌肠,整复成功199例(99%),失败2例(1%)。16例肠套叠行手术治疗,其中10例伴肠坏死,术后无病例死亡。结论:儿童急性肠套叠多见于2岁以下小儿,以4-10个月龄最多见。早期应行超声检查可以明确诊断,及时行空气灌肠整复率高,预后良好。
Objective To investigate the early clinical features and treatment principles of acute intussusception in children. Methods: A total of 196 patients with acute intussusception admitted from Tai’an Central Hospital from June 2010 to April 2012 were retrospectively analyzed. The clinical features, diagnosis, treatment and prognosis were retrospectively analyzed . Results: The children were 14 months younger than 4 months, 101 cases 4-10 months, 54 cases 11-24 months, 27 cases 24 months or older. 144 cases (34.4%) had abdominal pain, vomiting, bloody stool (23.3%) had paroxysmal crying only; 25 (11.6%) had only vomiting; 24 (11.6%) had only diarrhea; and 7 (3.3% Trouble; 20 cases (9.3%) vomiting, diarrhea; 15 cases (7.0%) had abdominal pain, vomiting, diarrhea. The coincidence rate of early ultrasound diagnosis of intussusception was significantly higher than those who did not perform ultrasound (P <0.05). In 196 patients with intussusception, air enema was performed. Nine hundred and ninety-nine patients (99%) had complete recovery and two failed patients (1%). Sixteen patients underwent intussusception surgery, of which 10 had intestinal necrosis and none died after the operation. Conclusion: Acute intussusception in children more common in children under 2 years of age, 4-10 months of age the most common. Early ultrasound should be able to make a clear diagnosis, timely air enema, the entire recovery rate is high, the prognosis is good.