頁籤選單縮合
題 名 | 小兒腸套疊 |
---|---|
作 者 | 黃二榮; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 20:1 1987.01[民76.01] |
頁 次 | 頁33-39 |
分類號 | 417.6244 |
關鍵詞 | 小兒; 腸套疊; |
語 文 | 中文(Chinese) |
中文摘要 | 國內有關小兒腸套疊之文獻發表較少,而且討論焦點只著重於臨床資料,本文除討論臨床結果外並深入評估手術適應症。 自1972年至1985年間,三軍總醫院及其相關醫院共經歷124例小兒腸套疊,資料分析後發現: (1)一歲以下小兒發生率較高(73.4%)。男女比率約為2:1。臨床症狀以嘔吐最多(79%),次為腹痛、血便、腹部腫塊(各為69%,66%及60%)。套疊部位以廻腸至大腸最多(94.4%),有病理導引點者占手術例的13%,其中以麥克爾憇室最多。 (2)本院第二階段之靜力復位成功率(61.5%)比第一階段(P<0.01)及相關醫院(P<0.05)的成績都好。可見有專門的小兒放射醫師與兒料及小兒外科配合才能創造較高的成功率。 (3)靜力鋇劑灌腸法既可診斷又可治療,是處理小兒腸套疊之首要考處步驟。但手術干預也有其適應性。在腹膜炎、休克、失敗的靜力復位、復發、新生兒例及腸阻塞等情況下必須採用手術復位。至於年齡大於3歲,病程長於2天或白血球數高於2萬之因素,靜力復位仍是首要考慮,不必立卽手術後位。 |
英文摘要 | Published literature concerning intussusception in infancy and childhood in Taiwan is relatively scarce and tends to concentrate primarily on analysis of clinical manifestations. In addition to that, a discussion of the surgical indications is considered useful after a series of investigations. Between 1972 and 1985 there have been 124 cases of infancy and childhood intussusception in TSGH proper (90 cases) and in associated hospitals (34 cases). Retrospective study revealed the following resu1ts. 1. The majority of patients are seen in infancy (73.4%), more frequently in males than in females (2: 1). Vomiting is the most prominent clinical feature (79%), followed by abdominal pain (69%), bloody stool (66%), and palpable abdominal mass (60%). The ileo-colic type (94.4%) is most common. The presence of pathological leading point is 13%, and Meckel's diverticulum is the most common. 2. Comparing the success rate of hydrostatic. reduction of second period (1982-1985) in TSGH with that of the first period (1972-1981) in TSGH and associated hospitals, showed that the statistical result is significantly better(P<0.01 and 0.05 respectively) in the second period. This is due to the fact that better or more skilled pediatric radiologists and better cooperation among pediactricians, pediactric surgeons and radiologist developed during the second period. 3. Hydrostatic barium enema can be both diagnostic and therapeutic; it should be the first consideration in management. Absolute surgical reduction should be considered immediately to conditions such as: peritonitis, shock, unsuccessful hydrostatic reduction, recurrence, neonates and where there is intestinal obstruction. In the following three instances, hydrostatic reduction should still be tried before considering surgical intervention: 1. Children older than 3 years of age. 2. Duration of symptoms lasting longer than two days. 3. WBC >20000. |
本系統中英文摘要資訊取自各篇刊載內容。