ABSTRACT
Objective:To evaluate the risk factors for prognosis of primary intussusception treated by enema reduction in children.Methods:A retrospective analysis of 519 patients with primary intussusception in Anhui Provincial Children′s Hospital from January 2017 to December 2020 was performed. Among the 519 patients, there were 346 males and 173 females. The median age was 15 months, with a range of 3 to 69 months, some basic information was collected. Patients were divided into bad prognosis group ( n=71) and good prognosis group ( n=448) according to prognosis.Propensity score matching (PSM) was conducted to reduce confounding bias between the groups. Conditional logistic regression were used to analysis the risk factors of primary intussusception treated by enema reduction. Results:There were 71 cases of poor prognosis among 519 primary intussusception patients, incidence was 13.7%.Before PSM, there was significant difference in 6 covariates, including gender, age, duration of symptoms, bloody stool, diarrhoea and fever between two group ( P<0.05). There was no significant difference in abdominal pain and vomit between two group ( P>0.05). With propensity score matching, 69 pairs of patients were sucessfully matched. After PSM, distribution of the above covariates reached equilibrium between two groups ( P>0.05). There were statistically significant differences in enema reduction, mass location, seroperitoneum, lactic acid and overweight/obese between the two groups ( P<0.05). Conditional logistic regression analysis confirmed that enema reduction( OR=3.478, 95% CI: 1.150-10.517, P=0.027), mass location ( OR=6.596, 95% CI: 1.669-26.056, P=0.007), lactic acid( OR=1.012, 95% CI: 1.003-1.021, P=0.010), overweight/obese ( OR=6.085, 95% CI: 1.650-22.436, P=0.007) were independent factors for predicting prognosis of primary intussusception treated by enema reduction. Conclusions:AER, mass located left hemicolon, elevated lactic acid and overweight/obese were independent risk factors for poor prognosis of primary intussusception treated by enema reduction.
ABSTRACT
Objective To evaluate the diagnostic value of magnetic resonance enterography(MRE)and ectopic gastric mucosa imaging(EGMI)in children with lower gastrointestinal hemorrhage.Methods The clinical data including gender,age,amount of bleeding and preoperative minimum hemoglobin(Hb)levels of 54 children with lower gastrointestinal hemorrhage were collected,who received surgical exploration in Department of Pediatric Surgery,Anhui Provincial Children's Hospital between February 2014 and April 2016.Children were divided into lesion group and non-lesion group according to the findings of surgical exploration.Lesion group were defined as children with Meckel's diverticulum(MD)or duplication of the small intestine by surgery and postoperative pathological findings.A total of 36 cases,25 cases of boys,11 cases of girls,aged(2.86±1.59)years old.Non-lesion group were defined as children,who underwent operation with negative result or with lesions but not MD or duplication of the small intestine.A total of 18 cases,14 cases of boys,4 cases of girls,aged(3.87±1.62)years old.MRE and EGMI were performed when the children stopped bleeding,before the inspection,should fasting for 4-6 h.SPSS 13.0 software was used for statistical processing.The evaluation of EGMI,MRE and the both in diagnosing MD or duplication of the small intestine were conducted by receiver operating characteristic curve(ROC).According to the principles of biggest gain best diagnostic value by Youden index,and the degree of sensitivity and specificity was calculated at this time,P0.05).There were statistically significant differences in age,amount of bleeding and preoperative minimum hemoglobin levels(t=2.179,2.027,2.222,all P<0.05).There were statistically significant differences in classification comparison by EGMI and MRE between 2 groups(x2=15.226,29.121,all P<0.01).The optimal cut-off value of EGMI and MRE in the diagnosis of enteric malformation was more than level 3,and the suspected positive and being positive value was assigned as positive results.According to the cut-off value above,EGMI,MRE and EGMI plus MRE in series and in parallel in the diagnosis of enteric malformation,the areas under curves(AUC)were 0.809,0.917,0.750 and 0.847,respectively.The sensitivity was 61.1％,75.0％,55.6％and 80.6％,respectively.The specificity was 90.4％,94.4％,94.4％and 88.9％,respectively.The Youden's indexes were 0.515,0.694,0.500 and 0.695,respectively.The optimal cut-off value of age and preoperative minimum hemoglobin levels in the diagnosis of enteric malformation were 2.92 years and 80 g/L,respectively.The AUC was 0.761 and 0.672.The Youden's indexes were 0.515 and 0.333.There was no significant differences statistically in AUC compared with age,MRE and EGMI(all P<0.05).Conclusions The high diagnostic value in children with lower gastrointestinal hemorrhage is found by using MRE and EGMI.Then,MRE as a separate diagnosis method is also worthy of clinical application.
ABSTRACT
OBJECTIVE@#To explore the clinical significance of high negative pressure drainage system (PFM) in treatment of pediatric neck abscess and postoperative scar.@*METHODS@#The clinical data of 35 children with neck abscess from June, 2012 to January, 2014 were retrospectively analyzed. According to the site of the abscess in children, a small incision drainage combined PFM were used, and the antibiotics were used at the same time to strengthen systemic support treatment. The complications were treated by the related departments, and the application of topical silicone gel incision after operation lasted for 3-6 months.@*RESULTS@#Thirty-five children healed after the above treatment in 7-14 d. The effective cure rate was 100%. The post-operation followed up for 6 months -1 year and no surgical incision scar was found.@*CONCLUSION@#Small incision drainage combined with PFM show the superiority of minimal invasion for the treatment of postoperative abscess drainage without the needs of replacing the gauze and drainage bottle, and physiological activities are not affected in the suffering children. The method can significantly reduce the pain of children during the change of medical prescription and the physician workload. It has the advantages of faster healing, shorter hospital staying, without obvious scar and abnormalities. The method is especially useful for deep and large abscess, and it is better than the traditional treatment methods.
Subject(s)
Child , Humans , Abscess , Therapeutics , Anti-Bacterial Agents , Cicatrix , Therapeutics , Drainage , Neck , Pathology , Retrospective Studies , Wound HealingABSTRACT
Objective To observe the curative effect that losartan potassium combined with enalapril used in treating Ⅳ phase diabetic nephropathy(DN). Methods Divided 74 Ⅳ phase DN suffers into 3 groups randomly.Losartan group:taken losartan potassium lablets 100 mg once every day orally,enalapril group:taken enalapril tablets 10 mg once every day orally,consociation group:taken the two drugs above ai one time with the same dosage.The treatment in the 3 groups were all above 3 years.monitoring the 24-hour albuminuria and SCr back and forth the treatment.Results It worthed statistics meaning that the 24-hour albuminuria in the 3 groups all declined(P＜0.05).The effect of consociation group did better(P＜O.01).In term of SCr,it declined in the consociation group worthed statisties meaning only.Conclusion The consociation application with losartan potassium and enalapril can control the proteinuria of Ⅳ phage DN suffers efficiently as well as defer process of kidney diseases.