Background: Neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory marker in abdominal pathologies. Ileocolic intussusception (ICI) involves a progressive intestinal inflammation, and the effectiveness of non-surgical treatment (enema) might be related to the inflammation degree, although no previous studies have investigated this relationship. Our aim is to identify predictors of the need for surgical treatment in ICI. Methods: A single-center, retrospective, case-control study was performed in children with ICI, who were treated with initial non-surgical management between 2005 and 2019, Patients were divided in 2 groups: A (effective enema) and B (need for surgery). Admission demographic, clinical and laboratory data were analyzed. Specificity and sensitivity of the different parameters as predictors of the need for surgical treatment were determined by receiver operating characteristic (ROC) curves. Results: 511 patients were included (410 group A; 101 group B), without statistically significant demographic differences. Group B presented significantly higher frequency of vomiting, bloody stools and longer median time since symptoms onset (24 vs. 8 hours; p<0.001). Group B presented higher median laboratory inflammatory markers than group A: NLR (6.8 vs. 1.8; p<0.001), neutrophils (10,148 vs. 7,468; p<0.001), CRP (28.2 vs.4.7; p<0.001). In ROC curve analysis, NLR had an area under the curve (AUC) of 0.925, higher than neutrophil count (0.776; p=0.001), CRP (0.670; p=0.001), and time since symptoms onset (0.673; p=0.001). It was estimated a cut-off point of NLR>4.52 (sensitivity: 73.2%; specificity: 94.5%). Conclusion: High NLR values imply a high degree of bowel inflammation and might anticipate the need for surgical treatment in ICI in children.

背景：中性粒细胞与淋巴细胞比率（NLR）是腹部病理学中新兴的炎症标志物。回结肠肠套叠（ICI）涉及进行性肠道炎症，非手术治疗（灌肠）的有效性可能与炎症程度有关，尽管之前没有研究探讨这种关系。我们的目的是确定 ICI 中是否需要手术治疗的预测因素。方法：对2005年至2019年间接受初始非手术治疗的ICI患儿进行单中心、回顾性病例对照研究，将患者分为2组：A组（有效灌肠）和B组（需要灌肠）用于手术）。对入院人口统计、临床和实验室数据进行了分析。不同参数作为是否需要手术治疗的预测因素的特异性和敏感性由受试者工作特征（ROC）曲线确定。结果：纳入 511 名患者（A 组 410 名；B 组 101 名），没有统计学上显着的人口统计学差异。 B 组呕吐、血便的频率明显较高，并且自症状出现以来的中位时间较长（24 小时与 8 小时；p<0 id=17>4.52（敏感性：73.2%；特异性：94.5%）。结论：NLR 值较高意味着高度的肠道炎症，并可能预示儿童 ICI 需要手术治疗。