摘要:
目的：探讨小婴儿术后肠套叠的临床特点，以减少其发生率、提高早期诊断率。方法：总结我院2例小婴儿术后肠套叠的临床资料，并结合相关文献进行回顾性分析。结果：1例3月患儿肠穿孔行末端回肠造瘘术后第8天发生肠套叠，再手术时，发现套叠肠段已坏死，遂行肠切除肠吻合并关瘘术，二次手术7天后因肠穿孔再次手术，术中发现原吻合口尚好，其近端肠管多处穿孔，遂再行肠造瘘术，病情平稳后转院治疗，经随访得知，转院1月后疑因“肠炎”渐加重而死亡；另1例35天患儿为先天性巨结肠行回肠造瘘术后第2天发生肠套叠，急诊剖腹探查，手法复位成功，痊愈出院。结论：小婴儿术后肠套叠较少见，临床症状、体征不典型，容易延误诊断，故对于腹部手术后的小婴儿，应积极预防术后肠套叠的发生，对已发生肠套叠患儿，做到早发现、早诊断、早治疗。
Abstract:
Purpose: To explore the clinical characteristics postoperative intussusception of small infant, re-duce the incidence, and improve the early diagnostic rate. Method: 2 cases of postoperative intus-susception of infants were fulfilled the inclusion criteria. Result: 1 case, a 3 month infant with ter-minal ileum colostomy for intestinal perforation occurred intussusception 8 days after surgery. When we operated again, we found the nested bowel had been necrotic, then excised the necrotic bowl and closed the fistula. 7 days later, the third operation was conducted because of intestinal perforation. There were many perforations in near-end of the intestinal canal, hence we did an enterostomy again. The patient went to another hospital when in a smooth condition, and died of the doubtful aggravating enteritis a month after leaving our hospital. Another case, a 35 days infant occurred intussusception 2 days after ileum colostomy for congenital megacolon, undergone laparotomy, reposited manually successfully, then recovered and discharged from hospital. Con-clusion: Postoperative intussusception of small infant is rare, and easy to delay in diagnosis because of atypical clinical symptoms and signs, so to small infant with abdominal surgery, it is necessary to prevent the occurrence of postoperative intussusception actively, and to those that have occurred postoperative intussusception, it should detect, diagnose and treat early.