摘要
目的:探讨空气灌肠复位失败肠套叠X线诊断的影像学表现,为指导临床治疗提供参考。方法:以2017年1月-2018年1月我院收治82例小儿肠套叠患者为研究对象,全部患儿均于X线引导下进行空气灌肠,复位失败后改行手术治疗。观察患儿手术结果及复位失败肠套叠X线诊断的影像学表现。结果:82患儿经手术治疗症状均解除,手术成功率100%。肠套叠类型:回-结-结型47例,回-回-结型21例,回-结型6例,回-回型5例,回-回-结-结型3例,其中复杂型肠套叠构成比最高,占86.59%。X线下观察可见复位失败肠套叠套头呈不规则形状,套头较长,空气加压灌注时,套头推进缓慢,在各肠断有停顿,或不推进,停滞在回盲部,套头随灌注气压大小而呈弹簧状收缩,但多次加压灌注套头均不消失。结论:空气灌肠复位失败肠套叠X线表现具有一定特征性,对于复位失败的患者,临床应早期改行手术,以减少并发症,保证治疗安全。
Objective： To investigate the imaging findings of intussusception X-ray diagnosis of air enema reduction failure and provide guidance for clinical treatment. Methods： From January 2017 to January 2018,82 patients with intussusception in our hospital were enrolled in the study. All patients underwent air enema under X-ray guidance. After failed to reset,they were treated with surgery. Then observed the surgical findings and the imaging findings of the failed intussusception X-ray diagnosis. Results： The symptoms of 82 children were relieved by surgery,and the success rate of surgery was 100%. Intussusception type： 47 cases of retro-junction-junction type,21 cases of retro-retro-junction type,6 cases of retro-responsive type,5 cases of retro-responsive type,3 cases of retro-retro-junction type,of which complex Type intussusception constitutes the highest ratio,accounting for 86. 59%. Observed under the X-ray,the failure of the intussusception showed an irregular shape,the head was longer,and when the air was pressurized and infused,the head pushed forward slowly,and there was a pause in each bowel,or did not advance,and stagnated in the ileocecal region.It was spring-like in size,but it did not disappear after multiple pressures. Conclusion： The intussusception X-ray findings of air enema reduction have certain characteristics. For patients with failed reposition,the clinic should be diverted to surgery early to reduce complications and ensure the safety of treatment.
作者
陈文瑞
李昌利
龙纯
游剑雄
Chen Wenrui;Li Changli;Long Chung;You Jianxiong(Department of Radiology,The Central Peopleb Hospital of Zhanjiang City,Zhanjiang 524000,Guangdon)
出处
《现代医用影像学》
2018年第2期385-387,共3页
Modern Medical Imageology
关键词
肠套叠
空气灌肠
复位失败
X线
手术
Intussusception
Air enema
Failure to reset
X - ray
Surgery
