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目的分析小儿复发性肠套叠的临床特点及治疗。方法回顾性分析2002年1月-2010年12月本院3 730例肠套叠患儿的临床资料,其中复发性肠套叠395例。统计的内容包括一般情况、放射学表现和治疗结果。对于复发病例行进一步评估,并将不同治疗方法的复发率进行比较,分析不同治疗方法和复发之间的关系。应用SPSS 16.0软件进行数据处理。结果 3 730例肠套叠患儿中空气灌肠治疗3 729例,成功整复3 234例(86.7%),复发375例(11.6%)。空气灌肠治疗失败后行手术治疗495例,其中单纯手法整复474例,术后20例复发(4.2%);行肠切除21例(11.4%),其中3例存在基础病变:2例存在小肠憩室,1例存在肠系膜囊肿。复发性肠套叠患儿395例,共发生587次肠套叠,复发率为10.6%(395/3 730例)。首次发生肠套叠2岁内患儿占84.0%(332/395例)。复发时间间隔1 d～8 a,54.9%的复发性肠套叠发生在6个月内。空气灌肠治疗395例复发性肠套叠,整复成功345例(87.3%),与空气灌肠治疗初次肠套叠的成功率比较无统计学差异(χ2=0.044,P>0.05)。结论复发性肠套叠大多数是非特异性的,空气灌肠是首选治疗方式。开腹手术适用于空气灌肠整复失败、疑有病理诱因或多次复发的患儿。
Objective To analyze the clinical characteristics and treatment of recurrent intussusception in children. Methods The clinical data of 3 730 cases of intussusception in our hospital from January 2002 to December 2010 were analyzed retrospectively, including 395 cases of recurrent intussusception. The statistics include general information, radiological findings and treatment outcomes. For further assessment of relapse cases, and relapse rates of different treatment methods were compared to analyze the relationship between different treatment methods and recurrence. Application SPSS 16.0 software for data processing. Results A total of 3 729 cases of airway enema were enrolled in 3 730 cases of intussusception patients, of which 3 234 cases (86.7%) and 375 cases (11.6%) were successfully reconstructed. 497 cases were treated by air enema after operation failure, of which 474 cases were treated by simple manipulation and 20 cases were recurrent after operation (4.2%); 21 cases (11.4%) were performed intestinal resection, of which 3 cases had underlying lesions: 2 cases had small intestine Diverticulum, 1 case of mesenteric cyst. A total of 397 children with recurrent intussusception had a total of 587 intussusceptions, with a recurrence rate of 10.6% (395/3 730). The first episode of intussusception within 2 years of age accounted for 84.0% (332/395 cases). Relapse interval 1 d ~ 8 a, 54.9% of recurrent intussusception occurred within 6 months. Air enema treatment of 395 cases of recurrent intussusception, 345 cases of successful reconstruction (87.3%), and air enema for primary intussusception success rate was no significant difference (χ2 = 0.044, P> 0.05). Conclusion Most of the recurrent intussusception is nonspecific, air enema is the preferred treatment. Laparotomy for air enema failure, suspected pathological incentives or multiple recurrence of children.