Postpolypectomy syndrome without abdominal pain led to sepsis/septic shock and gastrointestinal bleeding:A case report

BACKGROUND Postpolypectomy syndrome(PPS)is a rare postoperative complication of colonic polypectomy.It presents with abdominal pain and fever accompanied by coagulopathy and elevated inflammatory markers.Its prognosis is usually good,and it only requires outpatient treatment or observation in a general ward.How-ever,it can be life-threatening.CASE SUMMARY The patient was a 58-year-old man who underwent two colonic polypectomies,each resulting in life-threatening sepsis,septic shock,and coagulopathy.Each of the notable manifestations was a rapid drop in blood pressure,an increase in heart rate,loss of consciousness,and heavy sweating,accompanied by shortness of breath and decreased oxygen in the finger pulse.Based on the criteria of organ dysfunction due to infection,we diagnosed him with sepsis.The patient also experienced severe gastrointestinal bleeding after the second operation.Curiously,he did not complain of any abdominal pain throughout the course of the illness.He had significantly elevated concentrations of inflammatory markers and coagulopathy.Except for the absence of abdominal pain,his fever,significant coagulopathy,and elevated inflammatory marker concentrations were all consistent with PPS.Abdominal computed tomography and superior mesenteric artery computed tomography angiography showed no free air or vascular damage.Thus,the diagnosis of colon perforation was not considered.The final blood culture results indicated Moraxella osloensis.The patient was transferred to the intensive care unit and quickly improved after fluid resuscitation,antibiotic treatment,oxygen therapy,and blood transfusion.CONCLUSION PPS may induce dysregulation of the systemic inflammatory response,which can lead to sepsis or septic shock,even in the absence of abdominal pain.

Glucomannan for abdominal pain-related functional gastrointestinal disorders in children:A randomized trial

AIM:To assess the efficacy of glucomannan(GNN) as the sole treatment for abdominal pain-related functional gastrointestinal disorders(FGIDs).METHODS:We conducted a double-blind,placebocontrolled,randomized trial.Patients were recruited among children referred to the Department of Paediatrics,Medical University of Warsaw.Included in the study were children aged 7-17 years with abdominal pain-related FGIDs classified according to the Rome Ⅲ diagnostic criteria.The children were randomly assigned to receive GNN,a polysaccharide of 1,4-D-glucose and D-mannose,a soluble fiber from the Japanese Konjac plant,at a dosage of 2.52 g/d(1 sachet of 1.26 g 2 times a day),or a comparable placebo(maltodextrin) at the same dosage.The content of each sachet was dissolved in approximately 125 mL of fluid and was consumed twice daily for 4 wk.RESULTS:Of the 89 eligible children,84(94%) completed the study."No pain" and "treatment success"(defined as no pain or a decrease ≥ 2/6 points on the FACES Pain Scale Revised) were similar in the GNN(n = 41) and placebo(n = 43) groups [no pain(12/41 vs 6/43,respectively;RR = 2.1,95%CI:0.87-5.07) as well as treatment success(23/41 vs 20/43;RR = 1.2,95%CI:0.79-1.83)].No significant differences between the groups were observed in the secondary outcomes,such as abdominal cramps,abdominal bloating/gassiness,episodes of nausea or vomiting,or a changed in stool consistency.GNN demonstrated no significant influence on the number of children requiring rescue therapy,school absenteeism,or daily activities.CONCLUSION:In our setting,GNN,as dosed in this study,was no more effective than the placebo in achieving therapeutic success in the management of FGIDs in children.

Upper Gastrointestinal Endoscopy in Children’s Abdominal Pains in Ivory Coast

Since a longtime considered as functional and psychological, children’s abdominal pains (CAP) is a public health problem. Advances in digestive endoscopy and Helicobacter pylori (H. pylori) discovery have reignited the debate of the organicity of CAP. The aim of this study is to determine the diagnosis rentability of upper gastrointestinal endoscopy (UGIE) in CAP in Ivory Coast. Patients and Methods: This a retrospective analytical study based on reports of UGIE performed in 2 university hospital and 3 private clinics of Abidjan from march 2007 to march 2016. The children (from 1 day to 15 years) in which UGIE were performed for abdominal pains were included in the study. Results: 116 UGIE were performed in children for abdominal pains during the study period. Epigastric pain was the main indication of UGIE (88%). The diagnosis rentability of UGIE was more than 70% in this study. The main anomalies observed in UGIE were gastropathies. Ulcers were rarely found. Conclusion: UGIE play an important diagnosis role in CAP in Ivory Coast. However gastric biopsies for Helicobacter pylori research are not common practice in our country.

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.

Autonomic functions and gastric motility in children with functional abdominal pain disorders

BACKGROUND Abdominal pain-predominant functional gastrointestinal disorders(AP-FGIDs)are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood.AIM To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs.METHODS One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques.RESULTS The main gastric motility parameters assessed(gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4],and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs(P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain(P < 0.05).Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities(P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone(maladaptive parasympathetic tone)(P< 0.05).CONCLUSION Children with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.

Paroxysmal drastic abdominal pain with tardive cutaneous lesions presenting in Henoch-Schnlein purpura

Henoch-Schnlein purpura(HSP) is a small-vessel vasculitis mediated by IgA-immune complex deposition.It is characterized by the clinical tetrad of non-thrombocytopenic palpable purpura,abdominal pain,arthritis and renal involvement.The diagnosis of HSP is difficult,especially when abdominal symptoms precede cutaneous lesions.We report a rare case of paroxysmal drastic abdominal pain with gastrointestinal bleeding presented in HSP.The diagnosis was verified by renal damage and the occurrence of purpura.

Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study

AIM To find the association between asthma and different types of functional abdominal pain disorders(FAPDs) among teenagers. METHOD A cross-sectional study was conducted among 13 to 15-year-old children from six randomly selected schools in Anuradhapura district of Sri Lanka. Data were collected using translated and validated selfadministered questionnaires(Rome Ⅲ questionnaire, International Study on Asthma and Allergies in Childhood questionnaire, and Pediatric Quality of Life Inventory 4.0) and administered under an examination setting after obtaining parental consent and assent.RESULTS Of the 1101 children included in the analysis, 157(14.3%) had asthma and 101(9.2%) had at least one FAPDs. Of children with asthma, 19.1% had at least one type of FAPDs. Prevalence rates of functional abdominal pain(FAP)(8.9% vs 3.3% in nonasthmatics), functional dyspepsia(FD)(2.5% vs 0.7%), and abdominal migraine(AM)(3.2% vs 0.4%) were higher in those with asthma(P < 0.05, multiple logistic regression analysis), but not in those with irritable bowel syndrome(4.5% vs 3.1%, P = 0.2). Severe abdominal pain(10.8% vs 4.6%), bloating(16.6% vs 9.6%), nausea(6.4% vs 2.9%), and anorexia(24.2% vs 16.2%) were more prevalent among asthmatics(P < 0.05). Lower gastrointestinal symptoms did not show a significant difference. Scores obtained for health related quality of life(HRQoL) were lower in those with asthma and FAPDs(P < 0.05, unpaired t-test).CONCLUSION Asthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs.

Unexplained abdominal pain due to a fish bone penetrating the gastric antrum and migrating into the neck of the pancreas: A case report

BACKGROUND Ingestion of foreign bodies results in gastrointestinal perforation in approximately 1% of patients,and fish bones are the objects that most commonly lead to bowel perforation. When it does occur,the terminal ileum is the most common site of perforation,followed by the duodenal C-loop. However,involvement of the pancreas is very rare. Because clinical symptoms are nonspecific and gastrointestinal perforation may present as only odynophagia or abdominal pain,a definite preoperative diagnosis and clinical intervention may be delayed.CASE SUMMARY We report the case of a 32-year-old man who presented to our hospital because of abdominal pain that had worsened over 5 d. He had no significant past history except that he had eaten fish 1 wk previously. Upper endoscopy revealed an irregular submucosal tumor on the front wall of the gastric antrum. Endoscopic ultrasonography and computed tomography showed a fish bone penetrating the gastric antrum and migratingin to the neck of the pancreas. The patient underwent laparoscopic surgery and had no complications one week after the operation.CONCLUSION A recent history of foreign body ingestion and imaging examinations are helpful for diagnosis of unexplained abdominal pain caused by foreign bodies.

Delayed diagnosis of abdominal Henoch-Schonlein purpura in children:A case report

BACKGROUND For children with abdominal Henoch-Schonlein purpura presenting abdominal pain as an initial symptom and severe clinical manifestations,but without purpura appearance on the skin,the diagnosis and treatment are relatively difficult.This study summarized the characteristics of this group of patients by literature review and provided additional references for further refinement of glucocorticoid therapy in this vasculitis.CASE SUMMARY A 6-year-old girl presented mainly with repeated abdominal pain and had received short-term out-of-hospital treatment with hydrocortisone.On day 7 after onset,gastroscopy revealed chronic non-atrophic gastritis and erosive duodenitis without purpuric rash,and no obvious resolution of the abdominal pain was found after treatment against infection and for protection of gastric mucosa.On day 14 the inflammatory indices continued to rise and the pain was relieved after enhanced anti-infective therapy,but without complete resolution.On day 19,the patient presented with aggravated abdominal pain with purplish-red dots on the lower limbs,by which Henoch-Schonlein purpura was confirmed.After 5 d of sequential treatment with methylprednisolone and prednisone,abdominal pain disappeared and she was discharged.CONCLUSION Henoch-Schonlein purpura-related rash may appear after long-term abdominal pain,and should be distinguished from acute and chronic gastrointestinal diseases at the early stage without typical rash.For bacterial infection-induced Henoch-Schonlein purpura,glucocorticoid therapy alone without clearing the infection may not relieve symptoms.

Evaluation of clinical outcomes in an interdisciplinary abdominal pain clinic: A retrospective, exploratory review

BACKGROUND Pediatric functional gastrointestinal disorders(FGIDs)are common and wellaccepted to be etiologically complex in terms of the contribution of biological,psychological,and social factors to symptom presentations.Nonetheless,despite its documented benefits,interdisciplinary treatment,designed to address all of these factors,for pediatric FGIDs remains rare.The current study hypothesized that the majority of pediatric patients seen in an interdisciplinary abdominal pain clinic(APC)would demonstrate clinical resolution of symptoms during the study period and that specific psychosocial variables would be significantly predictive of GI symptom improvement.AIM To evaluate outcomes with interdisciplinary treatment in pediatric patients with pain-related FGIDs and identify patient characteristics that predicted clinical outcomes.METHODS Participants were 392 children,ages 8-18[M=13.8;standard deviation(SD)=2.7],seen between August 1,2013 and June 15,2016 in an interdisciplinary APC housed within the Division of Gastroenterology in a medium-sized Midwestern children's hospital.To be eligible,patients had to be 8 years of age or older and have had abdominal pain for≥8 wk at the time of initial evaluation.Medical and psychosocial data collected as part of standard of care were retrospectively reviewed and analyzed in the context of the observational study.Logistic regression was used to model odds of reporting vs never reporting improvement,as well as to differentiate rapid from slower improvers.RESULTS Nearly 70%of patients followed during the study period achieved resolution on at least one of the employed outcome indices.Among those who achieved resolution during follow up,43%to 49%did so by the first follow up(i.e.,within roughly 2 mo after initial evaluation and initiation of interdisciplinary treatment).Patient age,sleep,ease of relaxation,and depression all significantly predicted the likelihood of resolution.More specifically,the odds of clinical resolution were 14%to 16%lower per additional year of patient age(P<0.001 to P=0.016).The odds of resolution were 28%to 42%lower per 1-standard deviation(SD)increase on a pediatric sleep measure(P=0.006 to P<0.040).Additionally,odds of clinical resolution were 58%lower per 1-SD increase on parent-reported measure of depression(P=0.006),and doubled in cases where parents agreed that their children found it easy to relax(P=0.045).Furthermore,sleep predicted the rapidity of clinical resolution;that is,the odds of achieving resolution by the first follow up visit were 47%to 60%lower per 1-SD increase on the pediatric sleep measure(P=0.002).CONCLUSION Outcomes for youth with FGIDs may be significantly improved by paying specific attention to sleep,ensuring adequate skills for relaxation,and screening of and referral for treatment of comorbid depression.

Gastrointestinal symptoms: A comparison between patients undergoing peritoneal dialysis and hemodialysis

AIM: To compare the prevalence and diversity of gastrointestinal (GI) symptoms in patients undergoing peritoneal dialysis (PD) and hemodialysis (HD).

Gastrointestinal side effects in children with Wilson's disease treated with zinc sulphate

AIM:To investigate the side effects of a zinc sulphate therapy in a cohort of Polish pediatric patients with Wilson's disease. METHODS:We retrospectively analyzed a cohort of 53 pediatric patients with Wilson's disease treated at the Children's Memorial Health Institute in Warsaw, Poland between the years 1996 and 2011 with zinc sulphate. Patients were diagnosed with Wilson's disease according to the scoring system of Ferenci, with 49 cases confirmed by mutation analysis. Data about the dosage scheme of zinc sulphate, side effects and efficacy and toxicity of the treatment were collected and recorded in the patient's medical chart at each visit to the hospital. RESULTS:Mean age of diagnosis for the entire cohort was 10 years (range, 2.5-17 years). Duration of treatment with zinc sulfate was 83.3 wk (range, 8-344 wk). Side effects, all of gastrointestinal origin, were observed in 21 patients (40% 9 males and 12 females), irrespective of the duration of therapy. Thirteen out of 21 patients were over the age of 10 years. The most common ATP7B mutation was p.H1069Q. Esophagogastroduodenoscopy, performed in 7 patients (33.3%) suffering from persistent and severe abdominal pain, revealed gastrointestinal ulcerations or erosions with negative Helicobacter pylori tests in all subjects investigated. The above mentioned 7 patients were treated with proton pump inhibitors. Three of those experienced resolution of symptoms, whereas proton-pump inhibitors failed to alleviate symptoms of the remaining four children and conversion of therapy to D-penicillamine was needed. CONCLUSION:Zinc sulphate appears to cause significant gastrointestinal side effects, which children on therapy for Wilson's disease should be closely monitored for.

Gastrointestinal symptoms in a Japanese population:A health diary study

AIM： To investigate the incidence of gastrointestinal symptoms and the nature of consequent utilization of health care services in a Japanese population. METHODS： Using self-report, we conducted a prospective cohort study of a nationally representative sample of the Japanese population over a one-month period to determine the incidence of gastrointestinal symptoms of all kinds and resultant health care utilization. Both information on visits to physicians and use of complementary and alternative medicine therapies were collected. RESULTS： From a total of 3568 in the recruitment sample, 3477 participants completed a health diary （response rate 97%）. The data of 112 participants with baseline active gastrointestinal diseases were excluded from the analysis, leaving 3365 participants in the study. The incidence of gastrointestinal symptoms was 250 and the mean number of symptomatic episodes was 0.66 in a month. Abdominal pain, diarrhea, nausea, constipation and dyspepsia were the most frequent symptoms. Female gender, younger age, and low baseline quality of life were risk factors for developing these symptoms. The participants were more likely to treat themselves, using dietary, complementary or alternative medicines, than to visit physicians, except in the case of vomiting.CONCLUSION： Gastrointestinal symptoms are common in the Japanese population, with an inddence of 25%. Abdominal pain, diarrhea, nausea, constipation and dyspepsia are the most frequent symptoms. Risk factors for developing these symptoms include female gender, younger age, and low baseline quality of life.

Electrocardiograms changes in children with functional gastrointestinal disorders on low dose amitriptyline

AIM: To study the effects of low dose amitriptyline on cardiac conduction in children.

Effect of fenugreek(Trigonella foenum-graceum L.)seeds powder on gastrointestinal bleeding in mechanically ventilated patients:A double-blind,randomized controlled clinical trial

Background:Stress ulcers are common in mechanically ventilated patients.They are the most common cause of gastrointestinal bleeding and are primarily associated with increased the consumption of nonsteroidal anti-inflammatory drugs.Despite advanced treatment,it has a high in-hospital mortality rate.This study assessed the effect of fenugreek(Trigonella foenum-graceum L.)seeds on gastrointestinal bleeding in mechanically ventilated patients.Methods:In this double-blind,randomized controlled clinical trial,60 mechanically ventilated patients hospitalized in intensive care units were equally distributed into intervention and control groups.The intervention group received 3 mg fenugreek seeds powder twice daily with a gavage solution for five days,in addition to routine treatment.The control group received only the gavage solution and routine treatment.The gastrointestinal bleeding and abdominal pain at admission and during the five days were assessed.Data were analyzed using SPSS software V.16,and the significance level was set at 0.05.Results:Gastrointestinal bleeding at admission was similar in both groups.The number of mechanically ventilated patients with gastrointestinal bleeding decreased on the third,fourth,and fifth days,but the difference was insignificant.The Cochran test results showed that the rate of stress-induced gastrointestinal bleeding in the control group increased significantly(P=.04).The decrease in gastrointestinal bleeding in the intervention group was not statistically significant(P=.08).Conclusion:The use of this drug reduces the gastrointestinal side effects of ventilated patient.Despite this,reducing gastrointestinal bleeding and similar mechanical ventilation complications in patients entirely dependent on the treating team is an important achievement.

基于“快速康复理念”探讨火龙罐综合灸疗法在腰椎融合术后的效用

目的:基于“快速康复理念”探讨火龙罐综合灸疗法在腰椎融合术后的应用效果,以期为临床早期康复方案的选择提供参考。方法:选择2022年2月至2023年2月于广东省中医院珠海医院脊柱科进行腰椎融合术治疗的126例患者,采用随机数字表法均分为观察组与对照组。对照组术后应用常规康复管理,观察组基于“快速康复理念”实施火龙罐综合灸疗法干预。比较两组康复效果、不良反应发生情况、术后各时间点腹痛程度、干预前后胃肠功能指标水平、临床干预满意度。结果:观察组胃肠功能指标恢复时间短于对照组(P<0.05);观察组术后腹胀腹痛及恶心呕吐总发生率为6.00%,低于对照组的20.00%(P<0.05)。术后8h、32h、56h,观察组VAS评分均低于对照组(P<0.05)。术后3天、术后5天,观察组胃肠激素指标高于对照组(P<0.05)。观察组满意率为96.00%,高于对照组的80.00%(P<0.05)。结论:火龙罐综合灸疗法干预能够显著提升腰椎融合术后患者康复速度,降低不良反应发生风险,同时对患者疼痛反应、胃肠道功能有持续改善作用,患者满意度较高,临床价值显著。

Non-pharmacological management of abdominal pain-related functional gastrointestinal disorders in children

Background:Abdominal pain-related functional gastrointestinal disorder(AP-FGID)comprises of 4 main conditions:functional dyspepsia,irritable bowel syndrome,abdominal migraine and functional abdominal pain.AP-FGIDs are diagnosed clinically based on the Rome IV criteria for FGIDs of childhood.There is limited evidence for pharmacological therapies.Data sources:This review article discusses non-pharmacological management of AP-FGID based on the current literature including systematic reviews,randomized controlled trials,cohort and case control studies.We aim to provide a comprehensive overview on the available evidence for the pediatricians and pediatric gastroenterologists involved in managing children with AP-FGID.Results:Managing AP-FGIDs can be challenging.This should follow a stepwise approach with focused history,identification of“red flag”signs and symptoms,physical examination and investigations done following initial consultation.Family needs explaining that there is nothing seriously wrong with the child’s abdomen.This explanation and reassurance can achieve symptom control in large number of cases.Non-pharmacological interventions are delivered through lifestyle and dietary changes and bio-psychosocial therapies.Dietary interventions vary depending on the type of AP-FGID.Bio-psychosocial therapies such as hypnotherapy,cognitive behavioral therapy and yoga aim at stress reduction.Conclusion:There is increasing evidence for use of non-pharmacological interventions in children with AP-FGID.

构建腹腔感染预警评分表对胃肠恶性肿瘤术后腹腔感染的预测分析

目的探讨构建腹腔感染预警评分表对胃肠恶性肿瘤术后发生腹腔感染的预测价值。方法选取2020年1月—2023年1月在医院行胃肠恶性肿瘤术的患者200例,按照术后是否发生腹腔感染分为腹腔感染组23例和非腹腔感染组177例,构建术后腹腔感染风险预测模型,采用Hosmer-Lemeshow检验模型的拟合度,采用受试者工作特征(ROC)曲线分析风险预测模型的价值。结果经单因素分析,年龄、性别、BMI、NRS2002评分、手术方式、手术时间、术中失血量、术后白蛋白、术后血红蛋白、糖尿病、高血压、心脏病、住院时间不是胃肠恶性肿瘤术后腹腔感染的影响因素(P>0.05),术后最高体温、术后最快心率、术后白细胞计数、术后腹痛、术后腹胀、术后降钙素原(PCT)是胃肠恶性肿瘤术后腹腔感染的影响因素(P<0.05)。经多因素二元Logistic分析,术后腹痛、术后腹胀、术后PCT≥2μg/L、术后最高体温≥37.5℃、术后白细胞计数≥9.95×10^(9)/L是胃肠恶性肿瘤术后腹腔感染的危险因素(P<0.05)。Hosmer-Lemeshow拟合度检验显示,χ^(2)=0.949,P=0.996。受试者工作特征(ROC)曲线显示,胃肠恶性肿瘤术后腹腔感染风险模型的曲线下面积(AUC)为0.880,约登指数为0.760,敏感度、特异度分别为78.26%、97.74%,实际应用的准确性为95.50%。结论本研究构建的胃肠恶性肿瘤术后腹腔感染预警评分表预测效果较好,可为胃肠恶性肿瘤术后腹腔感染提供辅助参考。

针灸促进腹部手术后胃肠功能恢复选穴规律分析

目的运用数据挖掘技术分析针灸促进腹部手术后胃肠功能恢复的选穴规律。方法通过检索中国知网、万方、维普数据库建库至2023年6月有关针灸促进腹部手术后胃肠功能恢复的文献,建立针灸促进腹部手术后胃肠功能恢复的处方数据库,对腧穴进行关联分析及聚类分析。结果纳入文献115篇,提取处方116首,包含腧穴61个,总频次575次;针灸促进术后胃肠功能恢复高频腧穴依次是足三里、上巨虚、内关;腧穴归经以足阳明胃经、任脉、足太阴脾经为主;重视下合穴、五输穴、募穴的使用;在腧穴配伍方面足三里分别与上巨虚、内关、三阴交、天枢相关性较高。结论通过对针灸促进腹部手术后胃肠功能恢复选穴及配伍规律分析,可为临床中术后胃肠功能的恢复治疗提供参考。

奥曲肽与泮托拉唑治疗消化性溃疡并发上消化道出血的疗效

目的探讨奥曲肽与泮托拉唑联合治疗消化性溃疡并发上消化道出血的效果。方法选取2018年5月—2020年12月在宁德师范学院附属宁德市医院接受治疗的70例消化性溃疡并发上消化道出血患者,基于随机数字表法分为对照组(n=35,给予“泮托拉唑”治疗)与观察组(n=35,给予“奥曲肽+泮托拉唑”治疗)。比较2组患者治疗效果及相关炎症因子水平情况。结果观察组与对照组治疗有效率[97.14%vs.82.85%]比较,差异有统计学意义(P<0.05)。观察组患者的黑便次数(0.60±0.19)次、止血时间(0.43±0.13)d、腹痛缓解时间(0.45±0.15)d,均明显低于对照组的(1.34±0.53)次、(1.06±0.42)d和(1.15±0.54)d(P<0.05)。观察组患者治疗后的血常规指标均明显优于对照组(P<0.05)。在炎症水平方面,观察组患者治疗后的炎症因子水平明显低于对照组,差异有统计学意义(P<0.05)。2组患者均未出现相关不良反应。结论对于消化并发上消化道出血,给予单一用药(泮托拉唑)的疗效不甚理想,但基于联合用药(“奥曲肽”与“泮托拉唑”)的综合效果更理想,可以有效控制出血、改善相关症状,并且血常规、炎症因子水平等改善效果更显著,用药安全。