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目的用手法整复辅助空气灌肠治疗小儿急性肠套叠,以提高其复位成功率。方法本组102例选择气压在8~12.5kPa之间,当套头在肠管内受阻,单纯空气灌肠复位效果欠佳时,采用双手全腹按压、局部套头按摩、单手套头推压来降低脱套阻力。结果 5例于结肠脾区受阻,16例于结肠肝区受阻,6例于升结肠区受阻,75例于回盲部受阻,经由手法整复后,95例复位成功,7例开腹手术,其中3例回回结型,2例回结型均出现肠坏死,1例为美克尔憩室,1例为恶性淋巴瘤。结论手法辅助空气灌肠治疗小儿肠套叠,双手全腹按压、局部套头按摩、单手套头推压可明显矫正肠腔内弯曲,与手术复位原则一致,缓解套入部痉挛、水肿、粘连,降低脱套阻力以加速肠套叠复位,从而有效提高复位成功率。
Objective To remedy the acute intussusception in children with assisted air enema by hand to improve the successful rate of reduction. Methods The group of 102 patients selected pressure between 8 ~ 12.5kPa, when the hedge in the intestine blocked, simple air enema reduction ineffective, with both hands full abdominal pressure, local hemorrhoids massage, resistance. Results 5 cases were blocked in the colon and spleen area, 16 cases were blocked in the liver area of the colon, 6 cases were blocked in the ascending colon area, 75 cases were blocked in the ileocecal area. 95 cases were successfully resected and 7 cases were laparotomy, Three of them returned to the nodules, and two of them returned to the intestinal junction with intestinal necrosis. One patient had merkel diverticulum and one patient had malignant lymphoma. Conclusions The method of assisted air enema in children with intussusception, hands full abdominal compression, partial hemorrhoids massage, single-handed head massage can significantly correct bowel bending, consistent with the principle of surgical reduction, ease the interventional spasm, edema, adhesions and reduce off Set of resistance to accelerate intussusception, reset, thereby effectively increasing the success rate of reset.