Application Of Non-fluoroscopic Air Enema In The Reduction Of Acute Intussusception In Children

Background and objective:Acute intussusception is the most common acute abdomen in infants and young children.The main disease is children under 1 year old,and the high incidence age is 4 to 10 months old.With the increase of the age of infants,the incidence of children after 2 years old gradually decreased,and even less after 5 years old.The disease occurs rapidly,if not treated in time,it is easy to cause intestinal necrosis,intestinal perforation,acute peritonitis and other complications,which is life-threatening.The treatment of acute intussusception can be divided into two methods: non-operative treatment and surgical treatment,while non-operative therapy is the main treatment of acute intussusception in children,including air enema,water enema and so on.Traditional non-operative therapy,such as air enema under X-ray fluoroscopy and water enema monitored by color ultrasound,may have the risk of exposure to radiation,or increase manpower cost and easy to cause pollution,so it is particularly important to find an enema method that can avoid X-ray radiation and reduce the clinical burden of health care workers.The method of non-fluoroscopic air enema has great advantages in this aspect,but there are few reports on non-fluoroscopic air enema reduction of infantile intussusception in domestic and foreign literature.This paper analyzes and discusses the treatment method of air enema reduction of infantile intussusception under non-fluoroscopy,and summarizes the reliability and practicability of non-fluoroscopic air enema in the treatment of infantile acute intussusception.Methods:The clinical data of 2195 children with acute intussusception treated in the Department of Pediatric surgery of the first Hospital of Jilin University from May 2010 to June 2016 were collected.All children were diagnosed by abdominal ultrasound,and routine evaluation was carried out before enema.Air enema contraindications were excluded,and then air enema without fluoroscopy was performed.In the process of enema,JS628 computer remote control air enema instrument was used to determine the reduction of intussusception according to the clinical manifestations of children in the process of intussusception.After the reduction was successful,Doppler ultrasound examination was performed after 30min-60 min.Statistical methods were used to analyze the sex,age distribution and reduction after enema of the clinical data of this group.Results:Of the 2195 children with intussusception,25 had contraindications for enema and underwent emergency surgery without air enema,which were excluded in this study.2170 children without contraindications were treated with non-fluoroscopic air enema,and reduction was successful in 2083 cases and failed in 87 cases,the success rate of reduction was about 95.99%.There were no complications such as intestinal perforation in children with air enema without fluoroscopy.The ratio of male to female was about 1.97,which was consistent with the male-to-female ratio of intussusception reported at home and abroad.The number of children under 1 year old was the most,followed by the interval of 1-2 years old,and the number of children decreased significantly after 3 years old,and the number of intussusception showed a decreasing trend with the increase of age.Linear regression analysis was carried out with age as independent variable and number of cases as dependent variable(p < 0.05),there was significant difference in statistics,which showed that the number of acute intussusception was closely related to the age of children.In the age group with more than 100 cases of enema,the reduction success rate was the highest in the age group of 1-2 years old(excluding 1 year old)and 2-3 years old(excluding 2 years old),and the male reduction success rate,female reduction success rate and total reduction success rate were all more than 97%,all were higher than the success rate of reduction in the age group of 1 year or less(the success rate of reduction was 91.56% for men,94.84% for women,and 92.86% for total).There was no significant difference in the success rate of reduction among different age groups and different genders(p > 0.05).Conclusion:Non-fluoroscopic air enema can avoid X-ray radiation,the reduction success rate is 95.99%,and the success rate is high.There is no significant difference in reduction success rate among children with acute intussusception of different ages and genders,as long as it meets the indications,non-fluoroscopic air enema is suitable for all kinds of acute intussusception.Non-fluoroscopic air enema is safe and reliable,easy to operate,has high application value,and is worth popularizing.