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相關文獻
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頁籤選單縮合
題名 | Clinico-pathological Features of Intussusception in Children Beyond Five Years Old=五歲以上兒童腸套疊的臨床病理特徵 |
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作者 | 賴文彬; 楊燿榮; 鄭兆能; 陳建旭; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 48:5 2007.09-10[民96.09-10] |
頁次 | 頁267-271+291 |
分類號 | 417.6244 |
關鍵詞 | 腸套疊; 兒童; 引導點; 大腸鏡檢法; Intussusception; Child; Leading points; Colonscopy; |
語文 | 英文(English) |
中文摘要 | 背景:較大的兒童發生腸套疊在病理發生學與預後上是與較小兒童不同的。本研究的目的是調查在一個醫學中心裡,大於五歲的兒童腸套疊所表現的特徵和預後。方法:從1988至2005年,使用回顧性的方法,執行調查經由手術後或是x光術診斷的五歲以上兒童的腸套疊;包括:臨床表現、診斷和治療方法、以及預後。結果:在17年之間,總共有12個病例,包括8個男生和4個女生,中位數年紀是7.6歲(範圍:5.0至11.1歲)。有4個兒童(33.3%)在確定診斷前,症狀持續超過一星期。最常見的症狀是腹痛(100%),接著的是噁心或併有嘔吐(75.0%)。反覆發生腸套疊的患者有33.3%。有11位病人接受腹部超音波檢查,診斷正確率爲百分之百。6位患者接受手術治療。在所有患者中有4例發現引起腸套疊的原因,包括2例惡性淋巴瘤、1例孟氏憇室、以及1例結腸息肉。四例發現原因的病人之中,有3例在手術前都可以由大腸鏡診斷或治療。術後的併發症爲腸沾黏(33.3%)及復發性腸套疊(16.7%)。所有患者包括那些有發現原因者,在經過適當的治療後,截至目前預後都良好。結論,較大兒童的腸套疊有較高比率產生持續症狀、病灶點、與復發。小兒科醫師需要注意較大兒童腸套疊的原因與治療的選擇。 |
英文摘要 | Background: The pathoetiology and outcomes of intussusception in older children are different from those in young children. This study aims to investigate the characteristics and outcomes of intussusception in children older than 5 years in a tertiary referring hospital. Methods: A retrospective review of patients aged older than five years having received a postoperative or roentgenographic diagnosis of intussusception between 1988 and 2005 was conducted. The clinical presentations, diagnostic and treatment methods, and outcomes of all cases were reviewed. Results: A total of 12 cases were recorded. They were eight males and four females, with a median age of 7.6 years (range 5.0-11.1 years). Four (33.3%) children had symptoms lasting more than one week before a prompt diagnosis was made. The most commonly encountered symptom was abdominal pain (100%), followed by nausea/vomiting (75.0%). Recurrent intussusception occurred in 33% of cases. Abdominal sonogram identified intussusceptum in all patients when this procedure was performed. Six patients were treated operatively. Lead lesions including two malignant lymphomas, one Meckel diverticulum, and one colon polyp were found in 4 cases. Three of the four lead points were diagnosed and treated by colonoscopy preoperatively. Complications after operations were adhesive ileus (33.3%) and recurrent intussusception (16.7%). All patients remained well, including those who had lead points identified after prompt treatments. Conclusions: Intussusception in older children presents a higher frequency of persistent symptoms, lead points, and recurrence. Pediatricians need to be aware of the etiology and treatment options for intussusception in older children. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。