目的：探究超声监视下0．9％氯化钠注射液灌肠复位术治疗肠道肿瘤肠套叠的治疗效果。方法选取2011年2月至2015年10月于恩施土家族苗族自治州民族医院就诊的肠道肿瘤并发肠套叠患者206例，依据随机数字表法分为试验组和对照组，各103例。试验组给予超声监视下0．9％氯化钠注射液灌肠复位及其他常规辅助治疗、护理方案进行治疗，对照组给予X线监视下加压空气灌肠复位术进行治疗，其余辅助治疗措施同试验组。观察比较两组患者转复耗时、转复成功率、穿孔率、手术率，治疗后36 h肠道功能低下和便血发生率，转复操作过程中的主观感受，以及治疗后呕吐及腹部胀痛情况。结果试验组患者转复耗时少于对照组[（18．95±5．36） min 比（22．02±7．38） min]，转复成功率显著高于对照组[94．17％（97／103）比80．58％（83／103）]，穿孔率及手术率均显著低于对照组[0．97％（1／103）比6．80％（7／103），4．85％（5／103）比16．50％（17／103）]（P＜0．05）。治疗后试验组患者的肠道功能低下及便血发生率显著低于对照组[11．65％（12／103）比25．24％（26／103），7．77％（8／103）比18．45％（19／103）]（ P ＜0．05）。治疗后试验组患者呕吐及腹部胀痛率显著低于对照组[17．48％（18／103）比31．07％（32／103），10．68％（11／103）比22．33％（23／103）]（P＜0．05）。试验组患者主观感受达标率均高于对照组[97．09％（100／103）比90．29％（93／103）]（P＜0．05）。结论超声监视下行0．9％氯化钠注射液灌肠复位术可明显提高转复速度及转复成功率，并且可以通过动态实时准确的监视明确病变部位，观察肠道壁压力承受情况，从而降低治疗过程中不良反应发生率，而且还可通过0．9％氯化钠注射液对肠道的润滑作用避免干结粪便对肠壁的损伤及治疗后便血的出现。%Objective To explore the effect of 0.9% NaCl injection reduction under ultrasound monitoring for tumor patients with intussusception .Methods From Feb.2011 to Oct.2015 ,206 cases of intestinal tumor with intussusception in the National Hospital of Enshi Tujia and Miao Autonomous Prefecture for treatment were divided into a trial group and a control group according to the random number table method ,103 cases each.The control group was given high pressure air enema reduction surgery under X-ray monitoring and other conventional adjuvant therapy for treatment ;the trial group was given 0.9%NaCl injection reduction surgery under ultrasound monitoring and the same adjuvant therapy as the control group.The cardioversion time consuming , the success rate of cardioversion , perforation rate , operation rate , the number of cases of intestinal dysfunction ,hematochezia 36 h after treatment ,patients′subjective feelings ,the number of cases of vomi-ting and abdominal pain before and after treatment of the two groups were observed and compared .Results The cardiover-sion time of the trial group was less than that of control group [(18.95 ±5.36) min vs (22.02 ±7.38) min],cardiover-sion rate was significantly higher than that of control group [94.17%(97/103) vs 80.58%(83/103)],the perforation rate and operation rate were significantly lower than those of control group [ 0.97%( 1/103 ) vs 6.80%( 7/103 ) ,4.85%( 5/103) vs 16.50%(17/103)](P<0.05).After the treatment,intestinal dysfunction and hematochezia rate of the trial group were significantly lower than those of control group [ 11.65%( 12/103 ) vs 25.24%( 26/103 ) , 7.77%( 8/103 ) vs 18.45%(19/103)](P<0.05).After treatment,the vomiting and abdominal pain rate of the trial group were significantly lower than control group [17.48%(18/103) vs 31.07%(32/103),10.68%(11/103) vs 22.33%(23/103)](P<0.05). The standard-reaching rate of subjective experience of the trial group was higher than the control group [ 97.09% ( 100/103 ) vs 90.29%( 93/103 ) ] ( P<0.05 ) .Conclusion Using 0.9% NaCl injection reduction surgery under ultrasound monitoring can improve the speed and success rate of cardioversion of intussusception , and it also can clear the lesion through dynamic real-time accurate monitoring,realize observation of the intestinal wall pressure ,and thereby reduce inci-dence of adverse reactions during the treatment ,at the same time,the 0.9%NaCl injection′s lubrication function can avoid damage of dry feces to the intestinal wall to reduce hematochezia after treatment .
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