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目的探讨大龄儿童肠旋转不良的诊治措施。方法对2002年10月-2009年11月本科收治的11例大龄儿童肠旋转不良病例进行回顾性分析。结果 4例术前行上消化道造影,发现十二指肠不全梗阻、空肠位置异常明确诊断;2例行钡灌肠检查见盲肠位置异常等征象而确诊;B超发现腹部“漩涡征”再经CT检查确诊4例;术中诊断1例。11例患儿经手术均得以证实。手术均行Ladd′s术,9例切除阑尾,平均住院天数为10.6 d,均痊愈出院。结论充分认识大龄儿童肠旋转不良的不典型临床表现有助于其早期诊断和治疗,早期诊断和正确的手术治疗是提高疗效的关键。
Objective To investigate the diagnosis and treatment of bowel dysplasia in older children. Methods A retrospective analysis was performed on 11 cases of malrotation of bowel malformation admitted to our hospital from October 2002 to November 2009. Results 4 cases of preoperative upper gastrointestinal angiography found duodenal obstruction, the location of jejunum was diagnosed abnormally; 2 cases of barium enema to see signs of abnormalities such as the location of the caecum diagnosed; B-abdominal “swirl sign” And then confirmed by CT examination in 4 cases; 1 case of intraoperative diagnosis. Eleven patients were confirmed by surgery. All patients underwent Ladd’s surgery. Nine patients underwent removal of the appendix. The average length of stay was 10.6 days. All patients were discharged. Conclusion It is of great significance to fully understand the atypical clinical manifestations of senile malrotation in older children, which is helpful for its early diagnosis and treatment. Early diagnosis and correct surgical treatment are the keys to improve the curative effect.