Clinical Features and Factors Affecting Success Rate of Air Reduction for Pediatric Intussusception
Journal of the Korean Association of Pediatric Surgeons
; : 108-116, 2010.
Article
em Ko
| WPRIM
| ID: wpr-166061
Biblioteca responsável:
WPRO
ABSTRACT
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.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Recidiva
/
Estações do Ano
/
Dor Abdominal
/
Modelos Logísticos
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Análise Multivariada
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Letargia
/
Febre
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Hospitalização
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Intussuscepção
/
Linfonodos
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Male
Idioma:
Ko
Revista:
Journal of the Korean Association of Pediatric Surgeons
Ano de publicação:
2010
Tipo de documento:
Article