超声引导下生理盐水灌肠和X线透视空气灌肠在小儿肠套叠复位中的比较

Comparison of ultrasound-guided saline enema and X-ray fluoroscopy air enema in the reduction of intussusception in children

目的 比较超声引导下生理盐水、X线透视空气灌肠在小儿肠套叠复位中的效果差异。方法 选择郑州大学附属儿童医院儿科病房2021年1月至2023年3月收治的90例小儿肠套叠患儿,运用随机数字表法原则,将其分为观察组及对照组,每组45例。对照组患儿采用X线透视空气灌肠复位,观察组患儿采用超声引导下生理盐水灌肠复位。对比2组患儿的复位成功率、复位时间,以及治疗前后患儿的胃肠激素水平变化和复发率情况。结果 观察组患儿复位成功率为97.78%(44/45),高于对照组的84.44%(38/45),但差异无统计学意义(P>0.05);观察组患儿复位时间<30 min的占比为70.45%(31/44),高于对照组的13.16%(5/38),差异有统计学意义(P<0.05);2组患儿治疗1、3 d的胃泌素与胃动素水平均较治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05);观察组患儿短期复发率为0,低于对照组的13.16%(5/38),差异有统计学意义(P<0.05)。结论 针对小儿肠套叠的复位操作,相较于应用X线透视空气灌肠复位方式,采取超声引导下生理盐水灌肠复位的成功率更高,复位时间更短,可有效改善胃肠激素水平,且复位后短期复发率低。

Objective To compare the effects of ultrasound-guided saline and X-ray fluoroscopy air enema in the reduction of children′s intussusception.Methods A total of 90 children with intussusception admitted to the pediatric ward of the Children′s Hospital Affiliated to Zhengzhou University from January 2021 to March 2023 were selected and divided into the observation group and the control group with 45 cases in each group by random number table method.The control group was treated with X-ray fluoroscopic air enema,and the observation group was treated with ultrasound-guided saline enema reduction.The success rate of reduction,reduction time,changes of gastrointestinal hormone levels before and after treatment,and recurrence rate of the children were compared between the two groups.Results The success rate of reduction in the observation group was 97.78%(44/45),which was higher than that in the control group(84.44%),but the difference was not statistically significant(P>0.05).The proportion of reduction time within 30 min in the observation group was 70.45%(31/44),which was higher than that in the control group(13.16%,5/38),and the difference was statistically significant(P<0.05).The levels of gastrin and motilin in both groups on the 1st and 3rd day of treatment were lower than those before treatment,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05).The short-term recurrence rate of children in the observation group was 0,which was lower than 13.16%(5/38) of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with the application of X-ray fluoroscopy air enema for the reduction of intussusception in children,ultrasound-guided saline enema has a higher success rate and shorter reduction time,which can effectively improve gastrointestinal hormone levels and lower short-term recurrence rate after reduction.