Clinical Features and Factors Affecting Success Rate of Air Reduction for Pediatric Intussusception

I. Son, K. Jung, Taejin Park, Hyun Young Kim, K. Park, Sung-Eun Jung
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引用次数: 2

Abstract

【Air reduction is a safe, effective, and fast initial treatment for pediatric intussusception. There is low dose radiation exposure. Factors affecting outcomes of air reduction were analyzed by reviewing the clinical features and results of treatment. A total of 399 out of 485 patients with pediatric intussusceptions were treated at the Seoul National University Children's Hospital from 1996 to 2009. All of the patients received air reduction as the first line of treatment. Clinical features such as gender, age, seasonal variation, symptoms, signs, types, pathologic leading point, and treatment results including success rate, complication, recurrence, NPO time, and duration of hospitalization were reviewed. The Pearson chi-square, student T-, and logistic regression tests were used for statistical analysis. P-value less than 0.05 was considered to be statistically significant. The prevalent clinical features were: male (65.4 %), under one-year of age (40.3 %), ileocolic type (71.9 %), abdominal pain (85.4 %), and accompanying mesentery lymph node enlargement (2.2 %). The overall success rate for air reduction was 78.4 % (313 of 399 patients), and the perforation rate during reduction was 1.5 %. There were 23 recurrent cases over 21.6 months. All were successfully treated with re-do air reduction. Reduction failures had longer overall NPO times (27.067hrs vs. 43.0588hrs; p=0.000) and hospitalization durations (1.738d vs. 6.975d; p=0.000) compared to the successful cases. The factors affecting success rates were fever (p=0.002), abdominal distension (p=0.000), lethargy (p=0.000) and symptom duration (p=0.000) on univariate analysis. Failure rates were higher in patients with symptom durations greater than 24 hours (p=0.023), and lethargy (p=0.003) on multivariate analysis. Air reduction showed high success rates and excellent treatment outcomes as the initial treatment for pediatric intussusception in this study. Symptom duration and lethargy were significantly associated with reduced success rates.】
小儿肠套叠空气复位的临床特点及影响成功率的因素
【空气还原是一种安全、有效、快速的小儿肠套叠初始治疗方法。】有低剂量的辐射暴露。通过回顾临床特点和治疗结果,分析影响空气减压效果的因素。从1996年到2009年,485名儿童肠套叠患者中有399人在汉城大学儿童医院接受了治疗。所有患者均采用空气复位作为一线治疗。回顾患者的性别、年龄、季节变化、症状、体征、类型、病理导点等临床特征,以及治疗成功率、并发症、复发率、NPO时间、住院时间等结果。采用Pearson卡方检验、student T-检验和logistic回归检验进行统计分析。p值小于0.05认为有统计学意义。主要临床特征为:男性(65.4%),1岁以下(40.3%),回肠结肠型(71.9%),腹痛(85.4%),伴肠系膜淋巴结肿大(2.2%)。空气复位的总成功率为78.4%(399例患者中有313例),复位时穿孔率为1.5%。复发23例,21.6个月。所有患者均成功进行了空气还原处理。减少失败的总NPO时间更长(27.067小时比43.0588小时);P =0.000)和住院时间(1.738d vs. 6.975d;P =0.000)。单因素分析影响成功率的因素为发热(p=0.002)、腹胀(p=0.000)、嗜睡(p=0.000)和症状持续时间(p=0.000)。多因素分析显示,症状持续时间大于24小时(p=0.023)和嗜睡(p=0.003)的患者失败率较高。在本研究中,空气减压术作为小儿肠套叠的初始治疗方法,成功率高,治疗效果好。症状持续时间和嗜睡与成功率降低显著相关。
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