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目的分析急性肠套叠空气灌肠致肠穿孔的临床和X射线表现,以尽可能减少肠穿孔的发生。方法选取1645例肠套叠患儿,其中男性950例,女性695例;年龄2个月至7岁,平均年龄3.6岁。经空气灌肠复位后,有6例患儿肠套叠空气灌肠致肠穿孔,其中男性4例,女性2例,年龄3~32个月,平均年龄为17.5个月;对其临床症状、X射线表现及手术情况进行回顾性分析,总结肠穿孔发生的病因。结果 6例均有阵发性哭闹、腹痛、呕吐及血便等临床表现。4例首次整复出现肠穿孔,2例再次灌肠出现肠穿孔,X射线表现气腹。手术治疗回结型4例,回回结型2例,6例回肠末端及结肠局部均见不同程度缺血坏死。结论提高肠套叠的认识,注意空气灌肠的适应证及操作方法可降低肠穿孔的发生。
Objective To analyze the clinical and X-ray findings of intestinal perforation caused by acute intussusception air enema in order to reduce the incidence of intestinal perforation. Methods A total of 1645 patients with intussusception were enrolled, including 950 males and 695 females, ranging in age from 2 months to 7 years with a mean age of 3.6 years. After air enema reduction, there were 6 cases of intestinal intussusception enema caused intestinal perforation, including 4 males and 2 females, aged 3 to 32 months, with an average age of 17.5 months; its clinical symptoms, X-ray The performance and operation were retrospectively analyzed to summarize the etiology of intestinal perforation. Results All patients had paroxysmal crying, abdominal pain, vomiting and bloody stools. In the 4 cases, intestinal perforation occurred in the first reconstructive process, and in 2 cases, intestinal perforation occurred again. The X-ray showed pneumoperitoneum. Surgical treatment of knot in 4 cases, 2 cases of return knot, 6 cases of ileal end and colon were seen varying degrees of ischemic necrosis. Conclusion To improve the understanding of intussusception, attention to the indications of air enema and operation methods can reduce the incidence of intestinal perforation.