공기 정복술을 시행 받은 소아 장중첩증 환자들의 치료 결과 및 성공률에 영향을 미치는 요인

손일태; 정규환; 박태진; 김현영; 박귀원; 정성은

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자료유형: 학술저널

저자정보: 손일태 (서울대학교 어린이병원 소아외과) 정규환 (서울대학교 어린이병원 소아외과) 박태진 (서울대학교 어린이병원 소아외과) 김현영 (서울대학교 어린이병원 소아외과) 박귀원 (서울대학교 어린이병원 소아외과) 정성은 (서울대학교 어린이병원 소아외과)

저널정보: 대한소아외과학회 Journal of the Korean Association of Pediatric Surgeons : JKAPS Journal of the Korean Association of Pediatric Surgeons : JKAPS 제16권 제2호

발행연도: 2010.1

수록면: 108 - 116 (9page)

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Air reduction is a safe, effective, and fast initial treatment for pediatric intussusception. There is low dose radiation exposure. Factors affecting outcomes of air reduction were analyzed by reviewing the clinical features and results of treatment. A total of 399 out of 485 patients with pediatric intussusceptions were treated at the Seoul National University Children's Hospital from 1996 to 2009. All of the patients received air reduction as the first line of treatment. Clinical features such as gender, age, seasonal variation, symptoms, signs, types, pathologic leading point, and treatment results including success rate, complication, recurrence, NPO time, and duration of hospitalization were reviewed. The Pearson chi-square, student T-, and logistic regression tests were used for statistical analysis. P-value less than 0.05 was considered to be statistically significant. The prevalent clinical features were: male (65.4 %), under one-year of age (40.3 %), ileocolic type (71.9 %), abdominal pain (85.4 %), and accompanying mesentery lymph node enlargement (2.2 %). The overall success rate for air reduction was 78.4 % (313 of 399 patients), and the perforation rate during reduction was 1.5 %. There were 23 recurrent cases over 21.6 months. All were successfully treated with re-do air reduction. Reduction failures had longer overall NPO times (27.067hrs vs. 43.0588hrs; p=0.000) and hospitalization durations (1.738d vs. 6.975d; p=0.000) compared to the successful cases. The factors affecting success rates were fever (p=0.002), abdominal distension (p=0.000), lethargy (p=0.000) and symptom duration (p=0.000) on univariate analysis. Failure rates were higher in patients with symptom durations greater than 24 hours (p=0.023), and lethargy (p=0.003) on multivariate analysis. Air reduction showed high success rates and excellent treatment outcomes as the initial treatment for pediatric intussusception in this study. Symptom duration and lethargy were significantly associated with reduced success rates.

#Intussusception #Air reduction #Success rate

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