超声引导下水压灌肠对急性肠套叠患儿应激反应及胃肠激素的影响分析

Analysis of the effects of hydrostatic enema under ultrasound guidance on stress response and gastrointestinal hormones in children with acute intussusception

目的分析超声引导下水压灌肠对急性肠套叠患儿应激反应及胃肠激素的影响。方法选取2019年4月至2021年7月该院实施水压灌肠治疗的80例急性肠套叠患儿作为研究对象,分为观察组(40例,水压灌肠治疗期间采用超声引导)和对照组(40例,水压灌肠治疗期间采用X线引导),对比2组急性肠套叠患儿治疗效果(复位时间、住院时间、大便隐血恢复时间、复位成功率、复发率)、应激反应(白细胞介素-6、肿瘤坏死因子-α、C反应蛋白)、胃肠激素(血清胃动素、神经降压素、胃泌素)及并发症发生率(呕吐、肠穿孔、腹胀)。结果观察组患儿复位时间、住院时间、大便隐血恢复时间明显短于对照组,复位成功率明显高于对照组,复发率明显低于对照组,差异均有统计学意义(P<0.05);2组患儿灌肠前白细胞介素-6、肿瘤坏死因子-α、C反应蛋白等应激反应指标和血清胃动素、神经降压素、胃泌素等胃肠激素指标水平比较,差异均无统计学意义(P>0.05)。出院前2组患儿各项应激反应指标和胃肠激素指标水平均较灌肠前显著改善,且观察组患儿改善情况显著优于对照组,差异均有统计学意义(P<0.05);观察组患儿呕吐、肠穿孔、腹胀等并发症发生率显著低于对照组,差异均有统计学意义(P<0.05)。结论超声引导下水压灌肠能有效降低对急性肠套叠患儿应激反应及胃肠激素的影响,提升患儿的治疗效果,减少并发症发生,其效果显著优于X线引导方式。

Objective To analyze the effect of hydrostatic enema under ultrasound guidance on stress response and gastrointestinal hormones in children with acute intussusception.Methods A total of 80 children with acute intussusception who were treated by hydrostatic enema in this hospital from April 2019 to July 2021 were selected as the study subjects and randomly divided into the observation group(n=40,guided by ultrasound during hydrostatic enema treatment)and the control group(n=40,guided by X-ray during hydrostatic enema treatment),and the treatment effects(time of reduction,hospital stay,recovery time of fecal occult blood,success rate of reduction,recurrence rate),stress reaction(interleukin-6,tumor necrosis factor-α,C-reactive protein)gastrointestinal hormones(serum motilin,neurotensin and gastrin)and the incidence of complications(vomiting,intestinal perforation and abdominal distension)were compared between the two groups of children with acute intussusception.Results The reduction time,hospitalization time,and recovery time of fecal occult blood in the observation group were significantly shorter than those in the control group,and the success rate and recurrence rate of reduction were significantly lower than those of the control group,with statistically significant differences(P<0.05).There was no significant difference between the two groups in the levels of stress response indexes such as interleukin-6,tumor necrosis factor-α,C-reactive protein and gastrointestinal hormones such as motilin,neurotensin and gastrin before enema(P>0.05).Before discharge,the levels of each stress response indicator and gastrointestinal hormone indicator in the two groups of children with acute intussusception were significantly improved compared with those before enema(P<0.05),and the improvementof the observation group was significantly better than that of the control group,with statistically significant differences(P<0.05).The incidence of complications such as vomiting,intestinal perforation and abdominal distension in the observation group was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion The hydrostatic enema under ultrasound guidance can effectively reduce the stress response and gastrointestinal hormones in children with acute intussusception,improve the treatment effect in children,and reduce the occurrence of complications,and its effect is significantly better than that of X-rayguidance.