新生儿及小婴儿肠套叠：三级转诊中心24年回顾性研究
该研究回顾24年间≤100天婴儿肠套叠病例，共纳入124例，中位年龄55天。小肠-小肠套叠占76%，多为偶然发现，仅2例需手术；回结肠套叠占24%，空气灌肠成功率80%且无穿孔，手术病例中13%发现病理性引导点。
要点
- ≤100天婴儿肠套叠中小肠-小肠型占多数，多为偶然发现，极少需干预。
- 肠管相关小肠-小肠套叠以保守处理（缩短或拔管）为主，均完全缓解。
- 回结肠套叠空气灌肠成功率高且安全，但病理性引导点比例高于年长儿。
核心结论
- 新生儿及小婴儿肠套叠中小肠-小肠型占主导且很少需要干预，回结肠型空气灌肠安全有效，但病理性引导点比例较高。
研究设计与样本
- 单中心24年回顾性研究，检索2000年1月1日至2024年7月31日≤100天婴儿放射学报告，排除影像阴性病例，最终纳入124例。
- 肠套叠分为小肠-小肠型、肠管相关小肠-小肠型和回结肠型，分析人口学、症状、影像及处理方式。
关键影像表现/征象
- 小肠-小肠套叠94/124例（76%），其中肠管相关36例（38%），大多为偶然发现。
- 回结肠套叠30例（24%），手术8例，病理性引导点4例（重复囊肿3例、梅克尔憩室1例）。
诊断标准与关键数值
- 回结肠套叠空气灌肠尝试26例，成功率80%（21/26），无穿孔发生。
- 回结肠套叠中特发性占87%，病理性引导点占13%。
临床应用与阅片要点
- 对≤100天婴儿小肠-小肠套叠，尤其肠管相关者，可优先保守处理，避免不必要手术。
- 回结肠套叠可首选空气灌肠复位，但需警惕病理性引导点可能，手术时注意探查。
局限性
- 单中心回顾性设计，仅纳入影像阳性病例，可能存在选择偏倚。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
BACKGROUND: Intussusception in neonates and young infants is rare, with limited data to guide management.
OBJECTIVE: This study aims to characterize the presentation, management, and outcomes of intussusception in infants ≤100 days of age.
MATERIALS AND METHODS: Radiology reports were searched for the keyword "intussusception" in infants ≤100 days over a 24-year period (January 1, 2000-July 31, 2024). Patient charts were reviewed, and cases with negative imaging studies were excluded. Data were analyzed for patient demographics, presenting symptoms, imaging, and management approach, including operative or non-operative interventions. Intussusceptions were classified as small bowel-small bowel (SB/SB), enteric tube-related SB/SB, or ileocolic.
RESULTS: Of 301 charts reviewed, 124 neonates and young infants ≤100 days of age met inclusion criteria (median age, 55 days; range, 0-100 days). SB/SB intussusception accounted for 94/124 cases (76%), which included 36 (38%) enteric tube-related. Most SB/SB cases were incidental findings, and only two required surgery. Management of enteric tube-related intussusceptions consisted primarily of conservative measures such as tube shortening or removal, with complete resolution and no case requiring surgery. Thirty infants (24%) had ileocolic intussusception. Air enema was attempted in 26, with a success rate of 80% (21/26) and no perforations occurred. Surgical intervention was required in 8 cases, revealing pathologic lead points in 4 cases (duplication cysts - 3; Meckel's diverticulum - 1), corresponding to 13% of ileocolic intussusceptions.
CONCLUSION: SB/SB intussusceptions predominate and rarely require intervention. Ileocolic intussusception accounts for 24% of cases, with air enema proving safe and effective in most cases. Most ileocolic intussusceptions are idiopathic (87%), with pathologic lead points identified in 13%, a higher proportion than reported in older children.
引用
- Rutten C, Koenig A, Zani A, et al. Neonatal and early infant intussusception: a 24-year retrospective review from a tertiary referral center. Pediatr Radiol. 2026. PMID: 42207258. doi:10.1007/s00247-026-06663-6
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。