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目的观察小儿肠套叠的内镜下特点,探讨内镜诊治肠套叠的应用价值。方法采用Pentax EC 3430型小儿电子大肠镜对79例肠套叠患儿进行大肠镜检查,同时利用内镜进行肠套叠整复,并与同期收治的82例采用 X 线下空气灌肠整复的肠套叠患儿的治疗结果相对照,比较两种治疗方法的差异。结果 2组患者的性别、年龄、体重、病程、主要临床症状分型等方面比较差异无统计学意义(P>0.05)。内镜整复79例,其中成功72例,诊断合并症32例(其中包括小儿结肠炎26例、结肠息肉4例、腹型过敏性紫癜2例),术后穿孔4例,3例无法整复而中转开腹手术治疗。空气灌肠整复82例,其中成功75例,诊断合并症0例,术后穿孔5例,2例无法整复而中转开腹手术治疗。2种方法在整复成功率以及术后穿孔率比较中差异无统计学意义(P>0.05)。在合并症的诊断中,内镜整复法明显优于空气灌肠整复方法。结论大肠镜检查可有效诊断肠套叠,并在内镜直视下整复治疗,也可有效诊断和治疗部分肠套叠合并症。
Objective To observe the characteristics of endoscopic intussusception in children and explore the value of endoscopic diagnosis and treatment of intussusception. Methods 79 children with intussusception using Pentax EC 3430 pediatric electronic colonoscopy were enrolled in this study. At the same time, intussusception was performed by endoscopy, and 82 patients undergoing X-ray air enema treatment Intestinal intussusception in children with the treatment of contrast, the difference between the two treatment methods. Results There was no significant difference in sex, age, body weight, course of disease and the main clinical symptoms between the two groups (P> 0.05). Endoscopic repair 79 cases, including 72 cases of successful diagnosis of complications in 32 cases (including 26 cases of pediatric colitis, colon polyps in 4 cases, 2 cases of abdominal hypersensitive purpura), postoperative perforation in 4 cases, 3 cases can not be the whole Re-conversion laparoscopic surgery. Air enema repair 82 cases, of which 75 cases of successful diagnosis of 0 cases of complications, postoperative perforation in 5 cases, 2 cases can not be reconstructive and laparotomy surgery. There was no significant difference between the two methods in the success rate of restoration and the postoperative perforation rate (P> 0.05). In the diagnosis of comorbidity, endoscopic repair was significantly better than the air enema consolidation method. Conclusions Colonoscopy can effectively diagnose intussusception and reconstruct treatment under endoscopy. It can also effectively diagnose and treat some intussusception complications.