目的 评价中药灌肠治疗各型便秘的疗效。 方法 计算机检索CBM、VIP、CNKI及Cochrane图书馆临床对照试验数据库等,查找符合纳入标准的随机对照试验,文献检索时间均从建库截至2012年5月。并按Cochrane系统评价手册的文献质量评价办法评价纳入研究的方法学质量,而后提取相关数据用Rev Man 5.1软件进行Meta分析。 结果 最终纳入15篇随机对照试验,共1 137名受试者。结果显示:中药灌肠治疗各型便秘的效果优于口服药、肥皂水灌肠、开塞露等其他治疗,OR值及相应95%CI分别为6.6(2.61,16.69)、5.46(2.57,11.60)、6.54(2.41,17.70)。 结论 中药灌肠治疗便秘有一定疗效且相对安全。由于纳入分析的研究质量差异较大,因此有必要进行大样本、多中心、随机、双盲的对照试验,以进一步证实其临床疗效。
目的 探讨婴幼儿肠套叠空气灌肠复位的指征、操作方法和中转手术的时机。方法 对我院1993~1998年5年间在X线透视下行空气灌肠复位治疗的婴幼儿肠套叠162例进行回顾性分析。结果 复位成功者148例,成功率为91.4%,其余14例中转手术治疗。随访1~5年,预后良好。结论 空气灌肠复位是婴幼儿肠套叠早期治疗的首选 方法,应谨慎把握其适应证,熟练掌握操作方法,不应轻易放弃而过早手术。但对病程较长,伴有腹膜炎体征或复位失败者,须及时手术治疗。
目的 比较电脑遥控灌肠整复仪与简易空气灌肠器对小儿肠套叠的整复效果,探讨更有效安全的空气灌肠设备。 方法 2002年11月-2011年11月对确诊的425例小儿肠套叠应用空气灌肠整复,其中198例采用简易空气灌肠器整复,227例用电脑遥控灌肠整复仪进行空气灌肠整复,并对不同病程时间、套叠部位与两种空气灌肠设备整复结果进行回顾性分析。 结果 198例患儿采用简易空气灌肠器整复成功率为71.2%,227例患儿采用电脑遥控灌肠整复仪的方式整复成功率为83.3%,后者成功率明显高于前者(P<0.005),尤其是病程时间在24 h内,套叠部位位于升结肠或横结肠的后者整复成功率更高(P<0.05)。 结论 电脑遥控灌肠整复仪比简易空气灌肠器更有效、安全。脉冲式空气灌肠能减轻套叠部位的痉挛与水肿,提高肠套叠的整复成功率。
ObjectiveTo investigate the diagnostic value of intra-intestinal angiography CT in patients with anastomotic leakage (AL) after rectal cancer resection.MethodsPatients who admitted to The Department of General Surgery of The No. 900 Hospital of The Joint Logistic Team from January 2013 to October 2018, who were diagnosed with rectal cancer and underwent rectal cancer resection with sphincter preserving surgery, were retrospectively collected in the study. All patients underwent routine imaging examination on the 7th day after rectal cancer operation. The retrograde contrast enema (RCE) was performed to obtain the abdominal X-ray film, then the pelvic CT scan was performed to get the CT image of the intestinal lumen. The films were reviewed by 2 senior radiologists, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RCE and intra-intestinal angiography CT in the diagnosis of AL after rectal cancer resection were evaluated. Evaluated the sensitivity of the CT image feature to predict AL after rectal cancer resection.ResultsThe sensitivity, specificity, PPV, and NPV of RCE in the diagnosis of AL after the rectal cancer resection were 69.23% (18/26), 98.64% (218/221), 85.71% (18/21), and 96.46% (218/226) respectively. The sensitivity, specificity, PPV, and NPV of intra-intestinal angiography CT were 96.15% (25/26), 99.09% (219/221), 92.59% (25/27), and 99.54% (219/220) respectively. The sensitivity and NPV of intra-intestinal angiography CT in diagnosis of AL were significantly higher than those of RCE (P<0.05). The sensitivity of contrast agent leakage to diagnosis of AL was the highest, reaching 96.15% (25/26).ConclusionsThe sensitivity of intra-intestinal angiography CT in the diagnosis of AL is high and the overall diagnostic efficiency is better than RCE, and the leakage of contrast agent is the main imaging feature of AL. It is significant to guide the clinical practice.
ObjectiveTo improve the efficacy of colon doublecontrast barium enema examination by using digital gastrointestinal machine and modified enema techniques. MethodsSixtyfour patients were examined on digital remote controlled gyration table, with oral coloncleansing preparation and selfmade disposable plastic bag. Results In 64 patients, up to 93.8% were found with none or little fecal materials in the cecum and ascending colon. 80% of the results were scored excellent, and 95% were accurate for making diagnosis. All the patients underwent the examination successfully. ConclusionDigital gastrointestinal machine examination combined with modified hypotonic doublecontrast barium enema is a simple, convenient and efficient way to clearly demonstrate colonic mucosa, and help increase the detection and diagnosis rate.