Résumé
Objective:To investigate and compare the therapeutic effect of Foley catheter balloon dilation and the traditional open reduction in the treatment of intussusception in children.Methods:A total of 68 children with intussusception treated by Foley catheter balloon dilatation by laparoscopic surgery or traditional open reduction in Department of Pediatric Surgery, the Second Hospital of Lanzhou University from August 2015 to July 2019 were retrospectively analyzed.Among them, there were 32 cases in the Foley catheter group and 36 cases in the traditional laparotomy group.Foley catheter group were treated with laparoscopic Foley catheter balloon dilatation, while the traditional open group were treated with traditional open surgery which was performed with finger dilatation.The results of surgical treatment, postoperative recovery, short-term complications, patient satisfaction and long-term complications were compared between the two groups.Results:Among the indexes of surgical treatment effect, the operation time[(0.4±1.1) h], intraoperative bleeding volume[(10.2±3.4) mL], incision size[(0.5±0.4) cm] and incidence of the rupture of intestine[6.3%(2/32 cases)] in the Foley catheter group were significantly lower than those in the traditional open group[(1.3±2.9) h, (40.5±2.1) mL, (5.1±0.7) cm, 30.6%(11/36 cases)], and the differences were statistically significant (all P< 0.05). Among the indexes of postoperative recovery and short-term complications, recovery time of gastrointestinal function[(1.2±3.1) d], length of hospital stay[(6.7±1.8) d], incidence of incision infection[9.4%(3/32 cases)]and incidence of incisional hernia(0) in the Foley catheter group were significantly lower than those in the traditional open group[(3.3±6.4) d, (7.3±0.9) d, 36.1%(13/36 cases), 16.7%(6/36 cases)], and the differences were statistically significant (all P<0.05). Among the indexes of family satisfaction and long-term complications, the score of family satisfaction in the Foley catheter group [(8.7±1.2) scores]was significantly higher than that in the traditional open group[(6.6±3.1) scores], and the incidence of adhesive intestinal obst-ructionin the Foley catheter group (0)was significantly lower than that in the traditional open group[0 vs.19.4%(7/36例)], and the differences were statistically significant(all P<0.05). Conclusions:Compared with traditional open reduction in the treatment of intussusception in children, Foley catheter balloon dilation has the advantages of short operation time, safe operation, low incidence of intestinal injury, less bleeding, and so on, and also has the advantages of small incision, fast recovery, short hospitalization time, high satisfaction of parents.In addition, the Foley catheter balloon dilation has a lower incidence of incisional infection, incisional hernia, postoperative intestinal adhesion and other complications.
Résumé
Objective To investigate the changes of serum procalcitonin (PCT), interleukin-6 (IL-6) and C reactive protein (CRP) in children with Henoch-Sch?nlein purpura (HSP) combined with surgical complications. Methods From January 2010 to June 2013, 48 children with HSP combined surgical complications were enrolled, the fasting venous blood were obtained in day 1, 3, 5 of admission and before discharge. Meanwhile, 30 healthy children were selected as control. Results Compared with the control group, the levels of serum PCT and IL-6 in day 1, 3, 5 of admission, and the levels of serum CRP in day 1, 3 of admission were higher in children with HSP combined with surgical complications (all P<0.01). The differences of levels of serum PCT, CRP and IL-6 in day 1, 3, 5 of admission and before discharge were statistically signiifcant between surgical group and non-surgical group. All these indicators showed a gradual downward trend. Compared with surgical group, the levels of serum PCT and IL-6 in day 3, 5 of admission and serum CRP in day 5 of admission were signiifcantly lower in non-surgical group (P<0.05). There were positive linear correlations between the level of serum PCT and IL-6, and between the level of PCT and CRP (r=0.48, 0.62, P<0.01). Conclusions The changes of serum PCT, IL-6 and CRP may be associated with the occurrence of surgical complications in children with HSP, monitor these indicators may help to assess the condition and to guide the treatment.