Effect Of Cleaning Enema Before ERCP On Postoperative Abdominal Symptoms

Objectives Objective: to study the effect of physiological saline cleaning enema before endoscopic retrograde cholangiopancreatography(ERCP)on postoperative intestinal mucosal barrier function of patients and the relationship between intestinal mucosal barrier and improvement of abdominal symptoms,and to explore the relevant mechanism?Methods 85 cases of patients who underwent ERCP in the first affiliated hospital of clams medical hospital were selected from February 2018 to June 2018,and the basic clinical data were collected and randomly divided into the experimental group and the control group.A total of 45 patients in the experimental group were treated with warm normal saline 500 ml cleaning enema 2 hours before surgery,and 40 patients in the control group were treated with indwelling blank control group before surgery.All patients were given water fasting for 8 hours before surgery,and intravenous access was reserved.Intramuscular injection of diazepam(10mg),pethidine(50mg)and anisodamine(10mg)was given 30 minutes before surgery.The contrast agent was iopromide.During the operation,EST,lithotomy and stent implantation were performed according to the patient's condition.After the operation,the patient should fast for 24 hours temporarily.Depending on the disease,the patient should be given liver protection,cholecystolipidemia,somatostatin to inhibit the secretion of trypsin,and appropriate amount of rehydration.Antibiotics should be used according to the situation.Meanwhile,serum endotoxin,serum lactic acid,blood CRP and blood amylase levels were measured 24 hours and 72 hours after surgery in the two groups,so as to evaluate the changes of postoperative intestinal mucosal barrier function between the two groups.Inclusion criteria:(1)All patients with ERCP surgery needle(2)patients enrolled voluntarily;Exclusion criteria:(1)can not tolerate enema;(2)involuntary enrollment?Results(1)A total of 85 patients with ERCP were collected in this study,including 45 patients in the experimental group,including 28 males and 17 females,with an average age of 45.1 2.69 years.The control group included 40 patients,including 26 males and14 females,with an average age of 50 2.82 years.There was no significant difference in gender or age between the two groups(P>0.05);(2)Blood endotoxin,blood lactate,blood CRP and blood amylase in the experimental group were significantly lower than those in the control group at different time points(3)The degree of abdominal pain and abdominal distension in the experimental group was significantly reduced compared with the control group?Conclusion Preoperative saline enema is simple,convenient operation,not only can clean the intestinal tract,discharge and gas accumulation feces,and in improving the stability of intestinal mucosa,reduce the permeability of intestinal mucosa,bacterial translocation play an important role,and accelerate the recovery of intestinal function,reduce the incidence of abdominal pain,abdominal distention,and qi tong,strong operability,worthy of clinical application,especially in the elderly,constipation,accompanied by touching the patient of postoperative abdominal symptoms?...