Chapter 2333： 【2333】Measurement of gain and loss

Chapter 2333 [2333] The measure of gain and loss

Reduction of intussusception by air enema is relatively safe. It is widely used in clinical practice and is very mature, but it has time requirements for patient conditions. For example, how many hours to do emergency treatment for myocardial infarction, otherwise the effect will be greatly reduced or even invalid.

Specifically, clinical cases have been counted. The data shows that this method has the highest success rate within 24 hours of the onset, which can reach more than 90%. More than 24 hours, there is a certain effect within 48 hours. After more than 48 hours, the intestinal folds are almost necrotic, and there is basically no effect of pumping up at this time, so surgery is required. Therefore, Xie Wanying said that she should seize the time to seize the last window within 48 hours.

Question You are close to 48 hours, the probability of intestinal necrosis is high, and the success rate of air enema is low. It is a big risk to try this for children.

is not to say that air enemas are without danger. The most dangerous part of an air enema is like inflating rubber. If you can't beat the drum, you can only add gas to increase the pressure. After the pressure is increased, the tube may burst in the lumen. A necrotic bowel has a greater chance of bursting the bowels with difficulty. In the human body, intestinal perforation is caused by intestinal perforation, and hemorrhage in the abdominal cavity.

Well, the doctor knows about this horrible complication, how about turning the pressure down hard. There is also a tricky complication waiting for you, or intussusception.

This statement sounds incredible to 80% of laymen: You use this method to solve how intussusception can cause intussusception?

Intestines are far more complicated than rubber tubes. The rubber tube has only one skin and is flat, the intestines are not.

Using the branch histological division in anatomy, the structure of the intestine can be divided into the mucous layer muscularis serosa. The most complex mucosal layer has a ring-shaped wrinkled wall structure, which is simply called wrinkled, which is a normal physiological phenomenon.

Intestinal mucosal folds are a physiological structure naturally evolved by the human body in order to retain the time when food passes through the intestinal tract, and the purpose is to allow the intestinal tract to absorb the nutrients of the food well.

You think, if the food slides through a smooth rubber tube and the food liquid passes through the intestines too quickly, how does the human body absorb the nutrients of the food, and it is difficult to absorb water.

When examining the digestive tract clinically, if you pay attention to some of the inspection reports, you can see the doctor's description of the intestinal folds. If there is a problem with the annular folds, this is part of the reason for the patient's indigestion.

Because of the special physiological structure of the intestines, if the intestines are pushed back after the gas enters the intestines, it may cause the dysfunction of other intestinal segments, and then cause intussusception in other parts. Whoever makes the wrinkled walls of the intestines is another potential factor that causes intussusception.

In a word, as long as the probability of intestinal necrosis is high, and you can't push it, let alone cure, there will be many complications. The probability of intestinal necrosis is proportional to the time of onset of the child.

In this way, the success rate of this child's air enema is not very high, and the doctor's focus must stay on complications. He is not a specialist in pediatric general surgery, and has few cases, so he has no experience in handling such cases. Knowing that there is this method, I am not sure that the problems that arise during the treatment can be solved, so I have to choose to give up.

Nothing is better than risking the child's life. Complications caused by doing so may be counted as medical malpractice. Doctors would never dare to take this risk.

(end of this chapter)