气蜡灌肠对小儿肠套叠复位作用

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1、气蜡灌肠对小儿肠套叠复位作用【摘要】目的提高小儿肠套叠灌肠复位率，避免肠穿孔意外发生。方法术前一律肌肉注射654-2，在无麻醉下取头低足高俯卧位插入Fuler’s肛管，灌肠器内放入10～20ml液体石蜡，术者手握带压力表的加压气球，保持低压（80mmHg内），慢速注气，透视观察套头部的运动变化，以套头部退出回盲部软组织块影消失，小肠进入气体为复位标准。术后禁食24h以静脉营养，抗感染、止血、解痉等药物治疗，24h后逐量进食。结果本组45例中2例超过48h，套头部位于横结肠脾曲，气压加至80mmHg时

2、套头部无明显移动，结合病史不排除肠坏死，未继续作复位术。43例全部行本法灌肠复位术均获成功。复位率94%～95%。其中2例进食过早12h复发，行第二次灌肠复位亦获成功。43例（45次）术中未出现肠壁穿孔等意外发生。肠坏死特征性表现：气压升至80mmHg时套头部无明显运动。结论于头低足高俯卧位，利用液体石蜡、654-2的药物特征性作用提高灌肠复位率，是小儿肠套叠的理论基础。低压慢速注气是避免肠壁穿孔的重要手段。本方法简便易行、安全可靠、复位率高。�【关键词】液体石蜡；654-2；低压慢速；气蜡灌肠复位

3、；肠套叠�� 9Theeffectofair-maxenemaonchildrenwithintussusceptionsLILing,WANGGuan-qing,WANGHao,etal.People’shospitalofXinzhou,Wuhan431400,China�【Abstract】ObjectiveItisimprovementingrateofchildintussusception,aviodancingaccidentofintestinalperforation.Method

4、sBeforeoperationI.Mone654-2whichtakethepositionofheadlowerandfoothigher,insertionFaleg’sCanal,intheenematersetin10-20mlfaraffinumliquidum,operatorhandgripsthesacculeofairthattakespressuretable,itisholdedpressureof80mmhg,slowerspeedinflation.fluoroscopy

5、observationairpressurepropelsintussusceptumintointestinumregressionoutfromileocecalvalves.thesofttissunemassimageisdisappearanced.Theairentrytheintestinal.Thefoodandwatercontremdicoled24hafteroperation.forVnutrition,anti-infection,homeostasis,spasmdysi

6、smedicinecare.thefoodiseatedfornumberprogressivemultipleafter24h.Results2caseintussusceptedlagssplenie9flexure.transversecolonamong45case.theintussusceptummigratesweakerwhenpressurerisesto80mmHg.theintestinalthanatosiscouldnotdepleteascombinediseasehis

7、tory.itisnotredact.43casehavegainedtotalsuccessaccordingtothemethods.thereductionrateis94-96%.among43case2casetakesinthefoodealierafter12hattack.secondredactacquiresuccesstoo,among43case(45case)operationhadnotoccurredintestinalperforation.Thetharanatos

8、isofintestinalcharacteristicX-rayexpression:theintussusceptedmigratesweakerwhenairpressureriseto80mmHg.ConclusionTheair-maxenemareductionintussusceptionofchildusespharmacologycharacteristicsof654-2andparaffinumliquidumthatismlussuseptio