摘要
总结术后肠套叠的临床特点及诊断方法。方法复习26例小儿术后肠套叠患者的临床资料及有关文献，分析其年龄特点、临床表现、诊断方法及预后。结果26例患儿2a以下20例（76．92％）。继发于腹膜后手术9例，腹腔内手术17例。术后出现胃管胆汁性胃液量增多或呕吐及腹胀症状的时间，术后1wk以内24例（92．31％）。血便、阵发性腹痛、腹部包块少见。腹部X线检查均提示肠梗阻；19例口服钡剂动态观察可确定其梗阻部位。手术证实术后肠套叠多为小肠套叠，占96．15％。本组除1例肠套叠时间较长，2例回肠复套，术中复位困难而行肠切除肠吻合外，其余23例均手法复位。26例均痊愈出院。结论术后肠套叠其临床表现不同于原发性肠套餐，与术后早期粘连性肠梗阻在发病时间上也有明显差别。对术后2wk内发生的肠梗阻，要考虑到肠套叠的诊断，尽早手术探查。
To summarize the clinical feature diagnosis and treatment of postoperative intussusception through the analysis of clinical cases.Methods: Twenty-six cases of postoperative intussusception were reviewed and their clinical manifestations, age characteristics diagnosis and prognosis were analyeed.Results: Twenty patients (76. 92%) were younger than 2 years of age. Wide variety of primary operations were confined to abdomen, 17 intra-peritoneum and 9 retroperitoneum. Symptoms included bilious vomiting, increased nasogastric drainage, or abdominal distension were recognized within 1 week in 24 children (92.31%) after surgery. rectal bleeding, abdominal pain and palpable abdominal mass seldom found. Plain abdominal radiongraphs demonstrated the loops of small intestine with distended air-fluid levels in all cases. The operation demonstrated that 25 cases were intussusception of small intestine,and one was ileo-colic. All the patients recovered after the second operation.Conclusion :Post operative intussusception is different from primary intestinal ones clinically. and also different from early-stage conesive obstruction at fhe onset. An ealier diagnosis and prompt laparotomy can be considered if intestinal obstruction occurs 2 weeks after surgery.Kevwords: intussusception; postoperation; children
出处
《实用儿科临床杂志》
CAS
CSCD
1999年第2期117-118,共2页
Journal of Applied Clinical Pediatrics
