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【2333】Weighing gains and losses

It is safer to use air enema to reduce intussusception. The commonly used technology is widely used in clinical practice and is very mature. However, it has time requirements on patient conditions. For example, how many hours must emergency treatment be given for myocardial infarction, otherwise the effect will be greatly reduced or even ineffective.

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Specifically, statistics on clinical cases have been conducted. The data shows that this method has the highest success rate when used within 24 hours of a child's attack, which can reach more than 90%. If it exceeds 24 hours, it will have a certain effect within 48 hours. If it exceeds 48 hours, it will have a certain effect.

The folded area of ​​the intestine was almost necrotic, and any further insufflation would have little effect at this time, so she needed surgery. So Xie Wanying said that she should seize the time and seize the last window within 48 hours.

The problem is that it is close to 48 hours. The chance of intestinal necrosis is high and the success rate of air enema is low. It is a big risk to try this for children.

This is not to say that air enema is not dangerous. The most dangerous part of air enema is that it is like inflating rubber to inflate it. If the rubber is not inflated, the only way to inflate it is to add gas and increase atmospheric pressure. When the pressure is increased, the tube may explode in the tube cavity.

Necrotic intestines are difficult to bulge and have a greater chance of bursting. In the human body, bursting of the intestines results in intestinal perforation and massive abdominal bleeding.

Well, doctors know about this scary complication, so how about lowering the pressure as hard as you can. There is also a tricky complication waiting for you, which is intussusception.

Eighty percent of laypeople find this inconceivable: You are using this method to solve intussusception. How can it cause intussusception?

Intestines are much more complicated than rubber tubes. Rubber tubes have only one layer of skin and are flat, while intestines are not.

Using branched histology in anatomy, the structure of the intestine can be divided into mucosal layer, muscular layer, and serous membrane. The most complex mucosal layer has an annular wrinkled wall structure. Simply put, it is called wrinkled, which is a normal physiological phenomenon.

Intestinal mucosal wrinkles are a physiological structure that the human body naturally evolved to save the time for food to pass through the intestines. The purpose is to allow the intestines to absorb the nutrients of food.

If you think about it, if the food slides through like a smooth rubber tube and the food liquid passes through the intestines too quickly, it will be difficult for the human body to absorb the nutrients of the food and water.

When clinically examining the digestive tract, if you pay attention to part of the examination report, you can see the doctor's description of the intestinal wrinkles. If there is a problem with the annular wrinkles, it means that part of the cause of the patient's indigestion lies here.

Because the intestines have such special physiological structures, if the invaginated intestine cannot be pushed back after inflating air into the intestines, it may cause functional disorders in other intestinal segments and cause intussusception in other parts. Who lets the wrinkled walls of the intestines

Duoduo is another potential factor that predisposes to intussusception.

In a nutshell, as long as the probability of intestinal necrosis is high and the patient cannot be pushed by pumping, there will be many complications, let alone cure. The probability of intestinal necrosis is directly proportional to the time of onset of the disease.

From this point of view, the success rate of air enema for this child is not very high, and the doctor's focus must remain on complications. He is not a specialist in pediatric general surgery, has handled few cases, and has no experience in handling such cases. Knowing that there is this method,

I was not sure that the problems that arose during the treatment could be solved, so I had no choice but to give up.

It is better not to do it than to risk the child's life. If it is done, complications may be attributed to medical malpractice. Doctors will never dare to take this risk.

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