目的 研究小儿原发性肠套叠（PPI）空气灌肠（AE）整复后复发相关危险因素。 方法 对2022年1月~2023年12月本院原发性肠套叠空气灌肠整复后患儿病例资料做回顾性分析。共计1449例次，根据患儿空气灌肠整复后72 h内是否复发将其分为复发组、非复发组，分别为181例次、1268例次，收集患儿临床资料作回顾性分析。对比两组年龄、性别、病程、包块直径、回盲部水肿、呕吐、腹痛、血便、嗜睡、近期呼吸道或消化道病毒感染病史、白细胞计数、C反应蛋白（CRP），分析影响原发性肠套叠空气灌肠整复后复发的相关因素，并对其做Logistic回归分析、Spearman分析以及ROC曲线分析，研究相关因素与原发性肠套叠空气灌肠整复后复发的相关性。 结果 复发组、非复发组在年龄、性别、病程、回盲部水肿、呕吐、腹痛、嗜睡、白细胞计数上均无明显差异（P>0.05），在近期呼吸道或消化道病毒感染病史、CRP、血便、包块直径上差异明显（P<0.05）；Logistic回归分析显示，近期呼吸道或消化道病毒感染病史、CRP、血便、包块直径是原发性肠套叠空气灌肠整复后复发的独立影响因素（OR=1.513、1.545、1.685、2.018，P<0.05）；Spearman分析显示，近期呼吸道或消化道病毒感染病史、CRP、血便、包块直径与原发性肠套叠空气灌肠整复后复发呈明显相关关系（r=0.221、0.364、0.238、0.412，P<0.05）；ROC曲线分析显示，近期呼吸道或消化道病毒感染病史、CRP、血便、包块直径对原发性肠套叠空气灌肠整复后复发具有一定预测作用（AUC=0.711、0.675、0.693、0.604，P<0.05）。 结论 近期呼吸道或消化道病毒感染病史、CRP、血便、包块直径与原发性肠套叠空气灌肠整复后复发密切相关，有近期呼吸道或消化道病毒感染病史、CRP水平升高、血便、包块直径>35 mm可能是原发性肠套叠空气灌肠整复后复发的独立危险因素。
Abstract
Objective To investigate the risk factors associated with recurrence after air enema (AE) reduction in pediatric primary intussusception (PPI). Methods A retrospective analysis was performed on clinical data of children with primary intussusception who underwent air enema reduction in our hospital from January 2022 to December 2023. A total of 1,449 cases were included and divided into a recurrence group (181 cases) and a non-recurrence group (1,268 cases) based on whether recurrence occurred within 72 h after AE reduction. Clinical data were collected for retrospective analysis. Age, sex, disease duration, mass diameter, ileocecal edema, vomiting, abdominal pain, bloody stool, somnolence, recent history of respiratory or gastrointestinal viral infection, white blood cell count, and C-reactive protein (CRP) were compared between two groups. Logistic regression analysis, Spearman analysis, and ROC curve analysis were used to identify factors associated with recurrence after AE reduction in primary intussusception and explore their correlations. Results There were no significant differences in age, sex, disease duration, ileocecal edema, vomiting, abdominal pain, somnolence, or white blood cell count between recurrence and non-recurrence groups (all P>0.05). There were significant differences in recent history of respiratory or gastrointestinal viral infection, CRP level, bloody stool, and mass diameter (all P<0.05). Logistic regression analysis showed that recent history of respiratory or gastrointestinal viral infection, CRP level, bloody stool, and mass diameter were independent risk factors for recurrence after AE reduction (OR=1.513, 1.545, 1.685, 2.018; all P<0.05). Spearman analysis indicated significant correlations between these factors and recurrence after AE reduction (r=0.221, 0.364, 0.238, 0.412; all P<0.05). ROC curve analysis showed that these factors had predictive value for recurrence (AUC=0.711, 0.675, 0.693, 0.604; all P<0.05). Conclusions Recent history of respiratory or gastrointestinal viral infection, CRP level, bloody stool, and mass diameter are closely associated with recurrence after AE reduction in primary intussusception. Independent risk factors may include recent viral infection, elevated CRP level, bloody stool, and mass diameter >35 mm.
关键词
小儿原发性肠套叠 /
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空气灌肠 /
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整复 /
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复发 /
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危险因素
Key words
Pediatric primary intussusception /
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Air enema /
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Reduction /
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Recurrence /
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Risk factors
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基金
南京医科大学科技发展基金(NMUB2019184)
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