空气灌肠整复术治疗小儿肠套叠的效果

Effect of Air Enema Reduction in Treatment of Pediatric Intussusception

目的分析空气灌肠整复术治疗小儿肠套叠的效果。方法选择2018年3月-2020年7月兴国县妇幼保健院收治的60例肠套叠患儿,按照住院号尾数的单双数分为试验组和对照组,各30例。对照组实施钡灌肠整复术,试验组实施空气灌肠整复术,比较两组炎性指标[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白介素-1(IL-1)]、胃肠激素[胃泌素(GAS)、胃动素(MTL)]、康复指标、复位及预后情况。结果术后24 h,两组TNF-α、hs-CRP、IL-1、GAS、MTL水平低于术前,且试验组低于对照组(P<0.05);试验组复位时间、便血改善时间、肠道功能恢复时间短于对照组,灌肠压力、术后2 h VAS评分低于对照组(P<0.05);试验组复位成功率为93.33%,高于对照组的66.67%(P<0.05);试验组24 h复发率、并发症发生率低于对照组,但差异无统计学意义(P>0.05)。结论小儿肠套叠应用空气灌肠整复术治疗具有复位时间短、灌肠压力小、复位成功率高、并发症发生率低等优点,且对胃肠道激素影响小,不会增强机体炎性状态,远期预后好。

Objective To analyze the effect of air enema in the treatment of pediatric intussusception.Methods Sixty children with intussusception admitted to Xingguo County Maternal and Child Health Hospital from March 2018 to July 2020 were selected and divided into experimental group and control group according to the odd and even numbers of the tails in the order of admission,with 30 cases in each group.The control group was treated with barium enema,and the experimental group was treated with air enema.The inflammatory indexes[tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP),interleukin-1(IL-1)],gastrointestinal hormones[gastrin(GAS),motilin(MTL)],rehabilitation indexes,reduction and prognosis were compared between the two groups.Results At 24 h after operation,the levels of TNF-α,hs-CRP,IL-1,GAS and MTL in the two groups were lower than those before operation,and those in the experimental group were lower than the control group(P<0.05).The reduction time,improvement time of hematochezia and recovery time of intestinal function in the experimental group were shorter than those in the control group,and the enema pressure and VAS score at 2 h after operation were lower than those in the control group(P<0.05).The success rate of reduction in the experimental group was 93.33%,which was higher than 66.67%in the control group(P<0.05).The 24 h recurrence rate and complication rate of the experimental group were lower than those of the control group,but the difference was not statistically significant(P>0.05).Conclusion Air enema reduction in the treatment of pediatric intussusception has the advantages of short reduction time,low enema pressure,high reduction success rate and low complication rate.And it has little effect on gastrointestinal hormones,does not enhance the inflammatory state of the body,and has a good long-term prognosis.