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儿童肠套叠复位后回盲部内镜特征分析及其与肠套叠发生的关系探讨

(2014-10-22 12:36:39)

          目的 通过肠镜观察研究回盲部在小儿肠套叠发病中的相关机制。

          方法 研究组选取106例用空气灌肠整复成功的急性肠套叠患儿,均在治疗成功后12 h行大肠镜检查,对照组为103例腹泻伴便血行大肠镜检查的患儿。2组患儿的年龄、性别、体质量差异无统计学意义。镜检观察回盲部征象改变:回盲瓣松弛、回盲瓣充血肿胀(脱垂)、回盲部炎性滤泡增生、回盲部黏膜损伤(充血、糜烂、瘀斑等),并作统计学分析。

          结果 研究组在回盲瓣松弛65例(61.3%)、回盲瓣充血肿胀含脱垂36例(33.9%)、回盲部滤泡增生106例(100.0%)、回盲部黏膜损伤33例(31.1%),和对照组比较,差异有统计学意义(P<0.05=。研究组内<1 y及>1 y患儿的上述内镜观察指标,差异亦有统计学意义。

          结论 儿童肠套叠的发生与回盲瓣形态功能变化紧密联系,1岁以内儿童发生肠套叠可能与回盲瓣松弛有关,且临床常表现为回结型肠套叠;1岁以上儿童发生肠套叠可能与回盲瓣充血肿胀(脱垂)有关,且临床常表现为回盲型肠套叠。

          关键词:回盲部; 肠套叠; 大肠镜检查; 儿童

    E-mail: haifeng1006@sina.com

    Image features of ielocecus under colonoscopy in intussusceptions children after successful reduction.

    Objective  To investigate the role of ileocecal valve in children patients with intussusceptions by colonoscopy after pneumatic air enema reduction.

    Methods  A total of 106 intussusceptions children patients, who recovered with pneumatic air edema reduction, were recruited to the study. They underwent colonoscopy within 12 hours after reduction. The control group was composed of 103 children patients with both diarrhea and hematochezia. There was no significant difference in age, sex or weight between the two groups. Colonoscopic findings were recorded in terms of slack, swelling, prolapsus, lymphoid hyperplasia and mucosal lesions in ileocecal valve.

    Results  In patients with intussusceptions, the rates of ileocecal valve slack, swelling including prolapsus, lymphoid hyperplasia and mucosal lesions were 61.3%, 33.9%, 100.0% and 31.1%, respectively, which were significantly different with those of the control group (P>0.05). When further divided intussusceptions patients into groups with age more than 1 yr or less, significant differences were also observed in regarding of these features.

    Conclusion  There is a close relationship between morphological and functional changes in ileocecal valve and intussusceptions in children. Ileocolic intussusceptions in patients younger than 1 yr is more likely to be due to slack of ileocecal valve, while that in patients older than 1 yr is mainly due to swelling or prolapse of ileocecal valve, represented by ileocecal intussuception.

    Key words: Ileocecal valve; Intussusception; Colonoscopy; Child

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个人资料
    刘海峰 单位:武警总医院
    所属科室:
    出生:1964-03-17
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