开塞露联合25%硫酸镁用于先天性巨结肠术前洗肠的临床研究

曾杰 林丽 曾凡颖 严纪虹 华妍

【摘要】 目的：探討开塞露联合25%硫酸镁用于先天性巨结肠（HD）术前洗肠的临床效果。方法：选择2020年8月-2021年5月就诊于本院儿外科的84例HD患儿，按随机数字表法将其分为研究组和对照组，每组42例。对照组术前使用常规回流式结肠灌肠，研究组使用开塞露联合25%硫酸镁保留灌肠后再实施回流式结肠灌肠。比较两组患儿痛苦程度、灌肠液总量、灌肠时间、住院费用、肠道清洁度、并发症发生情况。结果：研究组患儿痛苦程度轻于对照组，灌肠液总量、住院费用均少于对照组，灌肠时间短于对照组，差异均有统计学意义（P<0.05）。研究组肠道清洁度优于对照组，差异有统计学意义（P<0.05）。研究组并发症发生率低于对照组，差异有统计学意义（P<0.05）。结论：开塞露联合25%硫酸镁保留灌肠应用于HD术前洗肠，可减轻患儿痛苦，缩短术前肠道准备时间，提高肠道清洁率，减少灌肠液的使用量及并发症的发生，降低住院费用。

【关键词】 先天性巨结肠 开塞露 硫酸镁 回流灌肠

Clinical Study on the Use of Glycerine Enema Combined with 25% Magnesium Sulfate in Preoperative Colon Washing for Hirschsprung Disease/ZENG Jie， LIN Li， ZENG Fanying， YAN Jihong， HUA Yan. //Medical Innovation of China， 2021， 18（27）： -107

[Abstract] Objective： To investigate the clinical effect of Glycerine Enema combined with 25% Magnesium Sulfate in preoperative colon washing for hirschsprung disease （HD）. Method： A total of 84 HD children admitted to the pediatric surgery department of our hospital from August 2020 to May 2021 were selected， they were divided into study group and control group according to random number table method， 42 cases in each group. The control group used conventional reflux colon enema before operation， and the study group used Glycerine Enema combined with 25% Magnesium Sulfate retention enema before reflux colon enema. The pain degree， total amount of enema fluid， enema time， hospitalization cost， intestinal cleanliness and complications were compared between the two groups. Result： The pain degree of the children in the study group was lighter than that in the control group， the total amount of enema fluid and hospitalization cost were less than those in the control group， and the enema time was shorter than that in the control group， the differences were statistically significant （P<0.05）. The intestinal cleanliness of the study group was better than that of the control group， the difference was statistically significant （P<0.05）. The incidence of complications in the study group was lower than that in the control group， the difference was statistically significant （P<0.05）. Conclusion： The application of Glycerine Enema combined with 25% Magnesium Sulfate retention enema in preoperative enema of HD can reduce the pain of children， shorten the preoperative intestinal preparation time， improve the intestinal cleaning rate， reduce the use of enema fluid and the occurrence of complications， and reduce the cost of hospitalization.

[Key words] Hirschsprung disease Glycerine Enema Magnesium Sulfate Return flow enema

First-author’s address： Ganzhou Maternal and Child Health Hospital， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2021.27.026

先天性巨结肠（HD）属于小儿先天性消化系统发育畸形，是由病变肠管段狭窄痉挛，诱发功能性便秘或低位梗阻，造成近端肠管增厚增粗所致，以胎粪排出延迟、反复腹胀、便秘为主要表现[1-2]。手术是治疗HD的主要方式，術前回肠灌肠是手术准备的主要环节，灌肠质量将对手术效果造成直接影响[3]。传统灌肠法是将肛管插入肠腔，用注射器推注生理盐水，因扩张的肠腔存在较大的压力，易喷出粪水，污染患者和操作者，并易导致堵管，延长灌肠时间，增加患儿痛苦[4-5]。……