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目的:探讨小儿急性肠套叠的临床病因及手术治疗措施。方法:2006年8月～2009年1月选择住院治疗的小儿急性肠套叠患儿84例,其中男57例,女27例;年龄5个月～4岁,平均(1.8±0.6)岁,所有患儿均手术治疗。结果:血清GLU水平与性别有关,女性高于男性;GAS和MTL的性别差异无统计学意义,不同年龄的GAS、GLU和MTL水平差异无统计学意义。研究组急性期GAS和MTL水平显著升高,GLU水平显著下降;恢复期时GAS已下降至正常水平,GLU也上升到正常水平,但MTL变化不明显,仍维持较高水平。观察组84例患儿均治愈,随访1～5年,其中6例6个月后又出现肠套叠,经空气灌肠复位成功;3例因阑尾浆肌层损伤严重行阑尾切除术,8例切除回盲部的患者术后1年内大便次数较多较稀,伴轻度营养不良;余病例术后1个月内都有不同程度的大便次数增多,6个月后排便正常,发育营养接近同龄儿或较好。结论:胃肠激素紊乱在小儿急性肠套叠发病中起着重要的作用;根据病情选择适合的手术治疗方法,并在术后选择正确的处理方式是成功治疗急性肠套叠患儿、降低手术并发症的关键。
Objective: To investigate the clinical etiology and surgical treatment of acute intussusception in children. Methods: A total of 84 children with acute intussusception admitted to hospital from August 2006 to January 2009 were enrolled. Among them, 57 were male and 27 were female; mean age was (1.8 ± 0.6) years old from 5 months to 4 years old, All children were surgically treated. Results: The level of serum GLU was related to gender and the female was higher than male. The gender differences of GAS and MTL were not statistically significant. There was no significant difference of GAS, GLU and MTL between different ages. The acute phase GAS and MTL levels were significantly increased, GLU levels decreased significantly; convalescent GAS has dropped to normal levels, GLU also rose to normal levels, but the MTL did not change significantly, still maintain a high level. The observation group of 84 patients were cured, followed up for 1 to 5 years, of which 6 cases 6 months after the occurrence of intussusception, air enema reduction success; 3 cases of appendectomy due to severe muscular layer injury appendectomy, 8 cases Patients with ileocecal resection had more stools and more malnutrition within 1 year after operation, with more stools in different degrees within one month after operation, normal bowel movements after 6 months and close developmental nutrition Same age or better. Conclusion: Gastrointestinal hormone disorder plays an important role in the pathogenesis of acute intussusception in children. According to the condition, the appropriate surgical treatment is selected and the correct treatment after operation is to successfully treat children with acute intussusception and reduce the operation The key to complications.