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Objective:To investigate the effectiveness and safety of nasojejunal tube placement in children by gastroscopic drafting method.Methods:We retrospectively analyzed the clinical data of children with nasojejunal tube placement from January 2016 to December 2021 in our hospital, and compared the operation time, successful rate and complications of nasojejunal tube placement in the gastroscopic wire drawing method retraction group(observation group)and the gastroscopic foreign body clamp placement method placement group(control group).Results:All of the 167 cases, 65 cases were in observation group and 102 cases in control group.There were no significant differences in sex and age between two groups( P>0.05). The operation time was(6.7±0.8)min in observation group and(8.2±1.3)min in control group, and the difference was statistically significant( t=8.312, P<0.001). The successful rate was 100% in observation group and 96% in control group.One child in control group complicated with the mucosal erosion and bleeding in the duodenal bulb, while the observation group with no erosion, bleeding, perforation, and other complications. Conclusion:The gastroscopic wire drawing method of nasojejunal tube placement has a shorter operation time, higher successful rates, and lower complication rates, which is significantly superior to the gastroscopic foreign body clamp placement method.
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Objective:To analyze the clinical characteristics, endoscopic manifestations, complications and related risk factors of button battery ingestion in 58 children, thus providing the basis for clinical diagnosis and treatment.Methods:The medical data of 58 children with button battery ingestion were collected and researched at Children′s Hospital Affiliated to Zhengzhou University from September 2015 to September 2020.The demographic information, battery impaction location, duration, symptoms, mucosal injury level, battery size, treatment, complications and follow-up results were analyzed.Results:The average age of the patients with button battery ingestion was (25.7±15.4)months, including 40 boys(68.9%). The average retention time of the battery in digestive tract was 13.8(2, 96) h. Vomiting, salivation, dysphagia, cough and fever were the common chief complaints.There were 29(50.0%) cases of grade I mucosal injury, as well as 14(24.1%) cases, 10(17.2%) cases and 10(17.2%) cases for grade Ⅱ, grade Ⅲ and grade Ⅳ, respectively.Additionally, common complications included esophageal stenosis, esophageal perforation and esophageal-tracheal fistula.Logistic regression analysis showed that location(esophagus) and diameter(≥15 mm) of battery incarceration were important predictors of complications.Conclusion:The degree of mucosal damage is associated with the diameter and impaction location of battery.The button battery embedded in the esophagus is prone to complications, while the ones retained in the stomach were not vulnerable to serious complications.Endoscopy and other related examinations should be performed again in 1 to 3 weeks after the button removal to determine the outcome of complications and to intervene in time.
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Objective:To summarize and analyze the clinical characteristics of different treatment in children with esophageal foreign bodies.Methods:This study collected 246 children with esophageal foreign bodies in our hospital from January 2016 to January 2020, which was divided into endoscopic group and operative group.The general and clinical data of children treated with different treatment were collected and statistical analyzed.Results:There were 222 children in endoscopic group and 24 children in operative group, respectively.The rate of surgery was 9.75%.There were no significant differences in gender and location of esophageal foreign bodies.However, the average age of operative group was(2.92±2.67) years, which significantly younger than that in endoscopic group(4.12±3.37)years( P=0.049). The residence time in operative group(median 29.10 h)was remarkable longer than that in operative group(median 11.80 h)( P<0.001). The proportion of sharpness(50.00%) and corrosive(45.83%) foreign bodies in operative group were more than those in endoscopic group[16.22% and 8.11%( P<0.001)]. Moreover, the occurrence rate of major complication in operative group was 83.33%, which was dramatically higher than that in endoscopic group(0.90%)( P<0.001). Conclusion:The younger and longer residence time of esophageal foreign bodies in children contribute to the rate of operative treatment.Additionally, the sharpness and corrosive foreign bodies increase the risk of surgery and serious complications.
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Gastrointestinal foreign body is a common emergency in children, especially the esophageal foreign bodies or the sharp, corrosive, magnetic bodies, which highly induce the complications and urgently need treatment with endoscope.Moreover, the complications, including gastrointestinal bleeding, perforation, fistula and luminal stenosis, can be treated by using endoscope.Therefore, the characteristics and the therapy of high-risk gastrointestinal foreign bodies are illustrated.
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Objective To investigate the effects of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)on acute myocardial functional lesion after severe craniocerebral injury.Methods Sixty five examples with severe craniocerebral injury are collected in the 253th hospital of PLA from February in 2009 to May in 2012,of whom glasgow coma scale was low or equal to 8 points.They are examined creatine kinase-MB(CK-MB),cardiac troponin T(cTnT),TNF-αand IL-6 for correlative analysis while they are emer-gency treated at the same time.Results The myocardial function of the observe group examined results:CK-MB(198.63±37.72) U/L,cTnT(548.17±49.58)pg/mL;injury factors examined results:TNF-α(39.93± 18.88)ng/mL,IL-6(469.61 ±73.66)ng/mL.It both has evidently difference between the control group and the observe group and has obviously correlation between the my-ocardial function and injury factors of the observe group (P 0.911 4)and cTnT(r>0.942 1)had statistically significant difference.Conclusion TNF-αand IL-6 all participate in the process of the acute myocardial functional lesion after severe craniocerebral injury.The inchoate interference and treatment against TNF-αand IL-6 are possible to have inhibited the high expression of TNF-αand IL-6 in the blood and to improve the myocardial functional lesion after severe craniocerebral injury.
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Objective To investigate the correlation between tumor necrosis factor (TNF)-α,interleukin (IL)-6,platelet activating factor (PAF) with the blood coagulation disorder in severe craniocerebral injury.Methods Collected 65 subjects (observation group) with severe craniocerebral injury from January in 2009 to June in 2012 with the trauma index ≥17 points,glasgow coma scale ≤ 10 points,combined with other parts of the injury and died in the emergency department were excluded.Examined platelet count (PLT),activated partial thromboplastin time (APTT),prothrombin time (PT),D-dimer (D-D),TNF-α,IL-6 and PAF meanwhile were emergency treated,selected the same period 43cases of health as control group,these indicators were compared.Results PLT in observation group was significantly lower than that in control group [(74.91 ± 30.70) × 109/L vs.(191.52 ± 23.31) × 109/L] (P ＜0.01),APTT,PT in observation group was significantly longer than that in control group [(69.44 ± 15.52) s vs.(22.47 ± 9.41) s,(30.37 ± 8.22) s vs.(9.57 ±4.53) s] (P ＜0.01),D-D,TNF-α,IL-6,PAF in observation group was significantly higher than that in control group[(1 934.92 ± 708.49) U/L vs.(105.78 ± 44.53) U/L,(39.93 ± 18.88) μg/L vs.(1.28 ±0.59) μg/L,(417.61 ±73.66) μg/L vs.(63.93 ±41.49) μ g/L,(16 359.91 ±4 321.92) ng/L vs.(3 823.45 ±529.72) ng/L](P＜0.01).PLT in observation group was negatively correlated with TNF-α,IL-6 and PAF (r =-0.929 2,-0.944 5,-0.932 4,P ＜ 0.01),APTT was positively correlated with TNF-α,IL-6 and PAF (r =0.910 2,0.932 7,0.978 6,P ＜0.01),PT was positively correlated with TNF-α,IL-6 and PAF (r =0.934 1,0.955 4,0.978 6,P ＜ 0.01),D-D was positively correlated with TNF-α,IL-6 and PAF (r =0.942 1,0.943 8,0.941 8,P ＜ 0.01).Conclusions TNF-α,IL-6 and PAF all participate in the process of the blood coagulation disorder in severe craniocerebral injury.The inchoate interference and treatment such as lessening stress responses and inflammation responses against TNF-α,IL-6,PAF is possible to improve the blood coagulation disorder in severe craniocerebral injury and to decrease the death rate of patients.