肠套叠造成的肠壁缺血坏死,或造影剂灌肠(空气或造影剂)复位术均可能并发穿孔。在发达国家,症状出现时的穿孔率为 1%-3%[35]Stringer MD, Pablot SM, Brereton RJ. Paediatric intussusception. Br J Surg. 1992;79:867-876.http://www.ncbi.nlm.nih.gov/pubmed/1422744?tool=bestpractice.com且通常与诊断延迟有关。约 10% 肠套叠病例需肠道切除术。[5]Justice FA, Auldist AW, Bines JE. Intussusception: trends in clinical presentation and management. J Gastroenterol Hepatol. 2006;21:842-846.http://www.ncbi.nlm.nih.gov/pubmed/16704533?tool=bestpractice.com[29]Kia KF, Mony VK, Drongowski RA, et al. Laparoscopic vs open surgical approach for intussusception requiring operative intervention. J Pediatr Surg. 2005;40:281-284.http://www.ncbi.nlm.nih.gov/pubmed/15868598?tool=bestpractice.com 0%-6% 患者在尝试性造影剂灌肠复位术后发生穿孔;在有经验的医生操作的情况下,约 1% 会发生穿孔。[27]Daneman A, Navarro O. Intussusception. Part 2: an update on the evolution of management. Pediatr Radiol. 2004;34:97-108.http://www.ncbi.nlm.nih.gov/pubmed/14634696?tool=bestpractice.com 这些外科急症需进行紧急手术评估、肠套叠复位手术及坏死肠管切除术。对出现低血容量症状的婴儿建立适当的静脉通道并开始等张液体复苏之后,如怀疑穿孔则应给予广谱抗生素治疗。
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