...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Intussusception revisited: Is immediate on-site surgeon availability at the time of reduction necessary?
【24h】

Intussusception revisited: Is immediate on-site surgeon availability at the time of reduction necessary?

机译：肠套叠再访：缩小时是否有必要立即就医？

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE. The American College of Radiology recommends that fluoroscopically guided intussusception reduction be performed with a surgeon readily available. At many institutions, this may not be feasible. The purpose of this study was to assess the utilization of immediate surgical services at the time of radiologic intussusception reduction. MATERIALS AND METHODS. All radiologic intussusception reductions at a tertiary care children's hospital from November 2007 through August 2012 were reviewed to determine method, complications, clinical status of the child, and time between unsuccessful reduction and operative intervention. RESULTS. Among 433 patients with intussusception referred for fluoroscopic reduction, 86.1% (n = 373) had successful reductions, and 13.9% (n = 60) had unsuccessful reductions. Five perforations represented 8.3% (5/60) of the unsuccessful and 1.2% (5/433) of the total reduction attempts. Six patients' conditions became hemodynamically unstable during attempted reduction (four perforations, two unsuccessful reductions without perforation), representing 10% (6/60) of unsuccessful and 1.4% (6/433) of total reduction attempts. Percutaneous needle decompression and cardiopulmonary resuscitation restored hemodynamic stability in all cases. The mean time to surgery after perforation was 1.3 hours, after unsuccessful reduction complicated by hemodynamic instability was 2.2 hours, and after unsuccessful radiologic reduction without complication was 4.3 hours. CONCLUSION. In this series, complications requiring immediate medical or surgical attention were rare, occurring in 1.6% of cases (five bowel perforations, two cases of hemodynamic instability without perforation). On-site surgeon presence may not be necessary at the time of radiologically guided reduction attempts provided that the attending physician is facile with percutaneous needle decompression and management of hemodynamic instability and that ultimate surgical care can be arranged expeditiously.
机译：目的。美国放射学院建议，在容易获得的外科医生的指导下进行透视透视的肠套叠术。在许多机构中，这可能不可行。这项研究的目的是评估减少放射性肠套叠时即时手术服务的利用率。材料和方法。回顾了2007年11月至2012年8月在三级儿童医院进行的所有放射线肠套叠减少情况，以确定方法，并发症，儿童的临床状况以及减少失败与手术干预之间的时间。结果。在433例因荧光镜检查而减少肠套叠的患者中，成功减少了86.1％（n = 373），而没有成功减少了13.9％（n = 60）。五个穿孔占失败尝试总数的8.3％（5/60），占减少尝试总数的1.2％（5/433）。尝试减少的过程中有6名患者的状况在血液动力学上不稳定（4次穿孔，两次未穿孔但未成功减少），分别占失败尝试的10％（6/60）和总减少尝试的1.4％（6/433）。在所有情况下，经皮针头减压和心肺复苏可恢复血液动力学稳定性。穿孔后的平均手术时间为1.3小时，未成功复位并伴有血流动力学不稳定的平均时间为2.2小时，未成功完成放射学复位而未发生并发症的平均时间为4.3小时。结论。在这个系列中，需要立即就医或手术治疗的并发症很少见，发生在1.6％的病例中（五个肠穿孔，两个没有穿孔的血流动力学不稳定病例）。如果主治医师熟悉经皮穿刺减压和血液动力学不稳定的管理，并且可以迅速安排最终的手术护理，那么在放射指导的复位尝试中可能不需要现场医生在场。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号