Research The Effects Of The Anus Closed Side And Different Lower Limbs Fixation Methods In The Treatment Of Pediatric Intussusception With Air Enema

ObjectiveIn this study, we first examined impacts of rectal leak caused gas leak and unable to maintain high pressure in patients’ rectum, on therapeutic efficacy of using air enema in treating pediatric intussusception patients. Based on our observation, we designed different of lower lamb fixation methods, and studied therapeutic outcome when combine each of these method with air enema in treating pediatric intussusception patients with rectal leak. Materials and methods1.We recruited 160 cases of pediatric intussusception patients whom were treated with air enema in our hospital during July 2013 and Feb 2013. Among them, 153 patients were successfully treated with air enema, whereas 25 patients were not and successfully treated with surgery. Based on whether patients have rectal leak, we assigned patients into two different groups, then analysis averaged treatment time and therapeutic outcome between those groups.2.We randomly assigned all 211 cases of pediatric intussusception patients that recruited during March 2012 and Feb 2013 to 6 doctors to treat with air enema. One of doctor was asked to perform knee-join fixation accompany with air enema treatment, and other doctors don’t have to perform this procedure. Then, we measured beneficial effects of air enema treatment combine with knee-join fixation on the averaged treatment time, rectal leak during treatment and therapeutic outcome. Results1.53 of total 160(33.10%) cases pediatric intussusception patients were diagnosed with rectal leak, and the rest patients did not have rectal leak. Average treat time for patients with rectal leak were significant longer than those without rectal leak(10.25 min vs. 6.24 min, p<0.05). However, no obvious different were observed on the rate of successful treatment between each group(81.1% for patients with rectal leak vs. 86% for patients without rectal leak).2. We performed knee-join fixation in 32(15.1%) patients, whereas other performed lower-limb fixation in the rest 179 patients. The averaged time of air enema treatment combine with knee-join fixation is significant shorter than those treat with lower-limb fixation method(4.84 min vs.7.96 min, p<0.05). The rate of rectal gas leak was dramatically reduced in knee-join fixation group when compared with patients treated with lower-limb fixation method(3.1% vs.27.4%, p<0.05). However, different limb fixation method has no obvious different were observed on the rate of successful treatment(84.4% for knee-join fixation method vs.84.9% for the lower-limb fixation method). Conclusion1.Leak of gas during air enema treatment suggested rectal leak or impropriate fixation method will leads to increase of treatment time, thus will increase the risk of radiation exposure. Lower-limb fixation, combine with increase air pressure in Folly’s catheter and reduce the use of lubricant oil, should effectively prevent the incident of gas leak, helping maintain a stable rectum pressure, shorten the time for treatment. Thereby, reduce the risk of radiation exposure.2.When compare with regular lower-limb fixation method, using knee-join fixation method in treatment of pediatric intussusception patients with air enema gives better fixation successful rate, better seal of rectum, shorten the total treatment time. Thereby, reduce the risk of radiation exposure.