摘要
目的分析6年来陕西省小儿急性肠套叠的发病趋势和复发特点,探讨小儿急性肠套叠的流行病学特点及复发规律。方法选取2013年1月至2018年12月本院收治的3275例急性肠套叠患儿为研究对象。分析患儿的性别、年龄、临床症状、体征、彩超检查结果及治疗情况。结果3275例患儿中,男2194例,女1081例,男女比例为2.03∶1;其中<2岁患儿占比为69.65%;3个月至2岁是小儿急性肠套叠发病高峰期,且随着年龄增加,发病人数逐渐减少;大龄患儿(≥5岁)所占比例有逐年增高趋势。4~6月为小儿急性肠套叠的发病高峰期。小儿急性肠套叠的发病可能与年龄、体重、喂养方式、上呼吸道感染和腹泻有一定相关性。阵发性哭闹或腹痛的发生率随患儿年龄增长而升高,差异具有统计学意义(P<0.05);呕吐、便血、腹部包块的发生率随患儿年龄增长而降低,差异具有统计学意义(P<0.05);各年龄段患儿的彩超检查阳性率比较,差异无统计学意义(P>0.05)。初次空气灌肠复位3052例,复位成功率为85.75%(2617/3052);肠套叠复发132例,并给予239次空气灌肠复位治疗,复位成功率为92.89%(222/239),复发时给予空气灌肠复位的成功率高于初次,差异具有统计学意义(P<0.05)。肠套叠复发患儿中初次发病后1周内复套167次,占复发患儿的68.72%;662例患儿行手术治疗,术中发现继发性肠套叠患儿102例,占手术患儿的15.41%;继发性肠套叠中,年龄≥2岁的患儿75例,占继发性肠套叠患儿的73.53%。结论空气灌肠复位是治疗小儿急性肠套叠的有效措施,也是治疗复发性肠套叠的有效手段。<2岁小儿是急性肠套叠防治的重点人群,初次发病后1周内是预防肠套叠复发的关键时期,多次复发需考虑继发性肠套叠的可能。
Objective To discuss the epidemiological characteristics and recurrence law of acute intussusception in children by analyzing the incidence trend and recurrence characteristics of acute intussusception in children in Shaanxi province in the past 6 years.Methods A total of 3275 children with acute intussusception admitted in our hospital from January 2013 to December 2018 were selected as the research objects.The gender,age,clinical symptoms,signs,ultrasound examination results and treatment status of the children were analyzed.Results Among the 3275 children,there were 2194 boys and 1081 girls,the ratio of boy to girl was 2.03∶1;among them,children under 2 years old accounted for 69.65%;the peak incidence of acute intussusception in children was from 3 months to 2 years old,and the number of children gradually decreased with the increase of age;the proportion of older children(≥5 years old)showed an increasing trend year by year.April to June was the peak incidence of acute intussusception in children.The occurrence of acute intussusception in children might be related to age,weight,feeding method,upper respiratory tract infection and diarrhea.The incidence of paroxysmal crying or abdominal pain increased with the increase of age of children,and the difference was statistically significant(P<0.05);the incidences of vomiting,bloody stool and abdominal mass decreased with the increase of age of the children,and the differences were statistically significant(P<0.05);there was no significant difference in the positive rate of color Doppler ultrasonography among children of all ages(P>0.05).There were 3052 cases of initial air enema reduction,and the success rate of reduction was 85.75%(2617/3052);132 cases of intussusception recurred and 239 times air enema reduction treatments were given,the success rate of reduction was 92.89%(222/239),the success rate of air enema reduction at the time of recurrence was higher than that at the first time,and the difference was statistically significant(P<0.05).Among the children with recurrent intussusception,167 intussusceptions were performed within one week after the first onset,accounting for 68.72%of the children with recurrent intussusception;662 children underwent surgery,and 102 children with secondary intussusception were found during the surgery,accounting for 15.41%of the children who underwent surgery;among the secondary intussusception,75 children aged≥2 years old,accounting for 73.53%of the children with secondary intussusception.Conclusion Air enema reduction is an effective measure for the treatment of acute intussusception in children,as well as for the treatment of recurrent intussusception.Children under 2 years old are the key population for the prevention and treatment of acute intussusception,the key period to prevent the recurrence of intussusception is within 1 week after the initial onset,and the possibility of secondary intussusception should be considered for multiple recurrences.
作者
陈东
贾新建
魏强
CHEN Dong;JIA Xinjian;WEI Qiang(General Surgery Department,Children's Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710003,China)
出处
《临床医学研究与实践》
2022年第22期24-28,共5页
Clinical Research and Practice
关键词
小儿
急性肠套叠
流行病学
复发
children
acute intussusception
epidemiology
recrudescence
