注水结肠镜检查在慢性腹痛患儿诊治中的临床价值  

Clinical value of water injection colonoscopy in the diagnosis and treatment of children with chronic abdominal pain

作　　者：李大雷 孙军[1] 骆培良[1] 刘姜艳 李蓉 茆康卫[1] LI Da-lei;SUN Jun;LUO Pei-liang(Department of Pediatrics,Lianyungang First People's Hospital,Lianyungang Jiangsu 222000,China)

机构地区：[1]连云港市第一人民医院儿内科,江苏连云港222000

出　　处：《临床和实验医学杂志》2020年第19期2123-2127,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金青年基金项目(编号:81900772)。

摘　　要：目的探讨注水结肠镜检查在慢性腹痛患儿诊治中的临床价值。方法前瞻性选择连云港市第一人民医院2018年3月至2019年7月100例慢性腹痛患儿为研究对象,利用随机数字法将其分成注水组和注气组,每组各50例。注气组使用注气法结肠镜检查,注水组在注气组基础上采用注水辅助结肠镜检查。比较两组患儿临床指标(进镜时间、退镜时间、进镜长度、操作总时间)和检出率;对比两组患儿治疗前后视觉模拟疼痛(VAS)、波士顿肠道准备量表(BBPS)评分、肠道应激指标[皮质醇(Cor)、血管紧张素-Ⅱ(AngⅡ)]及炎症因子[肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)]水平差异,并统计两组患儿并发症发生情况。结果注水组患儿进镜时间显著低于注气组[(6.23±2.11)minvs.(7.29±2.09)min],差异有统计学意义(P<0.05)。注水组退镜时间、进镜长度和操作总时间与注气组比较[(5.34±1.24)minvs.(5.37±1.21)min、(68.31±4.36)cmvs.(68.33±4.41)cm、(24.17±5.30)minvs.(23.45±5.43)min],差异无统计学意义(P>0.05)。注水组检出率92.00%与注气组88.00%比较,差异无统计学意义(P>0.05)。两组治疗后VAS均较治疗前显著下降,BBPS评分显著升高,差异有统计学意义(P<0.05);注水组治疗后VAS评分显著低于注气组[(1.24±0.36)分vs.(1.47±0.33)分],BBPS评分显著高于注气组[(7.47±1.07)分vs.(7.01±0.93)分],差异有统计学意义(P<0.05)。两组治疗后Cor、AngⅡ显著高于治疗前,TNF-α、CRP和IL-6显著低于治疗前,差异有统计学意义(P<0.05);注水组治疗后Cor、AngⅡ、TNF-α、CRP和IL-6水平低于注气组[(216.14±13.36)μg/Lvs.(221.94±14.03)μg/L、(247.66±15.42)μg/Lvs.(256.87±15.51)μg/L、(16.35±3.47)ng/Lvs.(18.03±3.51)ng/L、(41.16±3.27)mg/Lvs.(43.33±3.52)mg/L、(0.21±0.09)pg/Lvs.(0.25±0.08)pg/L],差异有统计学意义(P<0.05)。注水组并发症总发生率10.00%与注气组6.00%比较,差异无统计学意义(P>0.05)。结�Objective To explore the clinical value of water injection colonoscopy in the diagnosis and treatment of children with chronic abdominal pain.Methods One hundred children with chronic abdominal pain in our hospital from March 2018 to July 2019 were selected as the research subjects,and they were divided into a water injection group and a gas injection group by random number method,each with 50 cases.The gas injection group used gas injection colonoscopy,and the water injection group used water injection assisted colonoscopy on the basis of the gas injection group.Compare the clinical indicators[entry time,exit time,enter length,total operation time]and detection rate of the two groups of children,compare visual analog pain(VAS),Boston(BBPS)score,bowel before and after treatment Tract stress indicators[Cortisol(Cor),angiotensin-Ⅱ(Ang II)]and inflammatory factors[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)]level differences,and finally statistics on the occurrence of complications in the two groups.Results The injection time of the water injection group was significantly lower than that of the gas injection group[(6.23±2.11)min vs.(7.29±2.09)min],and the difference was statistically significant(P<0.05).There was no statistically significant difference in the withdrawal time,the length of the lens and the total operation time between the two groups[(5.34±1.24)min vs.(5.37±1.21)min,(68.31±4.36)cm vs.(68.33±4.41)cm,(24.17±5.30)min vs.(23.45±5.43)min].The detection rate of the water injection group was 92.00%and the gas injection group was 88.00%.The difference was not statistically significant(P>0.05).After treatment,the VAS of the two groups were significantly lower than before treatment,and the BBPS score was significantly increased,and the difference was statistically significant(P<0.05);the VAS score of the water injection group after treatment was significantly lower than that of the air injection group[(1.24±0.36)points vs.(1.47±0.33)points],the BBPS score was signifi

关 键 词：小儿慢性腹痛 注水结肠镜 注气结肠镜 

分 类 号：R725.7[医药卫生—儿科]