气压和水压灌肠联合手法按摩治疗小儿难复性肠套叠疗效对比的研究

Pneumatic versus hydrostatic enemas in combination with massage for pediatric refractory intussusception

目的探讨X线下的空气灌肠与B超介导下的水压灌肠联合手法按摩治疗小儿难复性肠套叠的疗效。方法回顾分析2012年至2018年本院150例首次灌肠失败的肠套叠患者,再次行空气灌肠及水压灌肠,并结合手法按摩的病历资料将其分为空气灌肠组及水压灌肠组,各75例;观察两种治疗方法的整复成功率、复发率、穿孔率、复位时间及住院时间等数据。结果水压灌肠组复位成功率76.0%,高于空气灌肠组60.0%,差异有统计学意义(P<0.05);水压灌肠组复位时间(20.47±7.28)min,高于空气灌肠组(17.25±5.83)min,差异有统计学意义(P<0.05);两组患者住院时间比较,差异无统计学意义(P>0.05);经随访,水压灌肠组复发率为4.0%,低于空气灌肠组13.3%,差异有统计学意义(P<0.05)。结论B超介导下水压灌肠联合手法按摩治疗小儿难复性肠套叠,优于X线下空气灌肠联合手法按摩,方便快捷,安全性更高,疗效确切,取得良好的临床效果。

Objective To investigate therapeutic effects of pneumatic enema under X-ray and hydrostatic reduction under B-ultrasound with massage for pediatric refractory intussusception.Methods From 2012 to 2018,the clinical data of 150 children with intussusception who had failed enema reduction for the first time in our hospital were retrospectively analyzed.All the patients were divided into a pneumatic enema group and a hydrostatic enema group according to different therapies,with 75 cases in each group.The reposition success rates,recurrent rates,perforation rates,reposition times,and hospitalization times were compared between these two groups.Results The reposition success rate was higher in the hydrostatic enema group than in the pneumatic enema group(76.0%vs.60.0%;P<0.05).The reposition time was longer in the hydrostatic enema group than in the pneumatic enema group[(20.47±7.28)min vs.(17.25±5.83)min;P<0.05].There was no statistical difference in the hospitalization time between the two groups(P>0.05).The recurrence rate was lower in the hydrostatic enema group than in the pneumatic enema group(4.0%vs.13.3%).Conclusion Compared with pneumatic enema reduction,hydrostatic reduction under B-ultrasound with massage is better,more convenient,safer,and the clinical efficacy is certain.