论文部分内容阅读
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。
Summary postoperative intussusception clinical features and diagnostic methods. Methods The clinical data and relevant literatures of 26 patients with intussusception were retrospectively reviewed. The characteristics of age, clinical manifestations, diagnosis and prognosis were analyzed. Results 26 cases of children under 2a in 20 cases (76.92%). Secondary to retroperitoneal surgery in 9 cases, abdominal surgery in 17 cases. Postoperative gastric tube bile gastric juice volume or vomiting and bloating symptoms of time within 1wk after operation 24 cases (92.31%). Bloody stools, paroxysmal abdominal pain, abdominal mass is rare. Abdominal X-ray examination showed intestinal obstruction; 19 cases of oral barium dynamic observation can determine the site of obstruction. Surgical intussusception confirmed more intussusception, accounting for 96.15%. In addition to a group of patients with intussusception in a long time, 2 cases of ileal resection, intraoperative resection of intestinal resection difficulty with intestinal anastomosis, the remaining 23 cases were reset. 26 cases were cured and discharged. Conclusions The clinical manifestations of intussusception is different from that of primary intussusception, and there is a significant difference in the onset time between the early postoperative adhesive intestinal obstruction. Intestinal obstruction occurred within 2wk after surgery, to take into account the intussusception diagnosis, as soon as surgical exploration.