586例儿童急性肠套叠病例临床流行病学特征分析-现代医学

586例儿童急性肠套叠病例临床流行病学特征分析

单位：1. 厦门市儿童医院/复旦大学附属儿科医院厦门医院普外科, 福建厦门 361006;
2. 复旦大学附属儿科医院普外科, 上海 201102

分类号：R726

出版年·卷·期（页码）：2024·52·第三期（364-368）

摘要：

目的：分析厦门市儿童急性肠套叠的临床和流行病学特征，为临床诊治提供依据。方法：回顾性分析厦门市儿童医院2019年1月至2022年12月收治的586例急性肠套叠患儿临床资料，对患儿的性别、年龄、发病季节、临床症状、体征和治疗结果等进行分析。结果：586例患儿男女比例为2.17：1，男性患儿平均年龄大于女性患儿(Z=-2.356，P=0.018)。5~7月份发病率最高(217例，37.0%)。腹痛发生率在各年龄阶段差异无统计学意义(χ²=7.412, P=0.06)，呕吐发生率随年龄增长呈现下降趋势，各年龄组差异有统计学意义(χ²=56.989, P＜0.001)。血便最常见于＜1岁的患儿，且各个年龄组相比差异有统计学意义(χ²=13.060, P＜0.001)。首次灌肠成功率在1~2岁儿童中最高，随年龄增长逐渐降低，各年龄段差异有统计学意义(χ²=6.583, P=0.01)。复套发生率随年龄增长逐渐升高，各年龄组差异有统计学意义(χ²=20.563, P＜0.001)。灌肠治疗复位成功患儿腹痛和血便发生率低于灌肠失败行手术治疗患儿，差异有统计学意义(χ²=24.479、22.484,均P＜0.001)。结论：儿童急性肠套叠的发病与性别、年龄、季节有一定相关性。随着年龄增加患儿呕吐、便血的发生率降低，复套率升高。患儿性别与临床症状和灌肠结果无明显关系。出现腹痛和便血症状患儿最终接受手术治疗的几率较高。

Objective: To analyze the clinical and epidemiological characteristics of acute intussusception in children in Xiamen, and to provide evidence for clinical diagnosis and treatment.Methods: A retrospective analysis was conducted of the clinical data of 586 children with acute intussusception who were admitted to the Xiamen Children's Hospitalfrom January 2019 to December 2022. The data included the gender, age, season of onset, clinical symptoms, signs, and treatment outcomes of the children.Results: The male to female ratio was 2.17：1, and the average age of male children was higher than that of female children(Z=-2.356, P=0.018). The incidence rate was the highest in May to July(217 cases, 37.0%). There was no statistically significant difference in the incidence of abdominal pain across all ages(χ²=7.412, P=0.06), and the incidence of vomiting showed a decreasing trend with age, with a statistically significant difference across all age groups(χ²=56.98, P＜0.001). Bloody stool was most common in children<1 year old and the difference was statistically significant compared to all age groups(χ²=13.060, P＜0.001). The success rate of the first enema was the highest in children aged 1-2 years and gradually decreased with age, with a statistically significant difference between age groups(χ²=6.583, P=0.01). The recurrence rate increased gradually with age(χ²=20.563, P＜0.001). The incidence of abdominal pain and bloody stool in children with successful enema reduction was lower than that in children with surgical treatment for enema failure, and the difference was statistically significant(χ²=24.479, 22.484, all P＜0.001).Conclusion: The incidence of acute intussusception in children is related to gender, age, and season. With increasing age, the incidence of vomiting and bloody stool in children decreases, and the recurrence rate increases. The gender of the children was not significantly related to the clinical symptoms and enema results. Children with abdominal pain and blood in the stool have a higher chance of eventually undergoing surgery.

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