Effect of manipulative reduction combined with air enema on intestinal mucosal immune function in children with
Yang Li1, Han-Liang Jiao2, Yu-Kun Bai3
1Yang Li, Department of Minimally Invasive Surgery, Hebei Children's Hospital, Shijiazhuang, 050031, Hebei, P.R. China.
Insights
Manipulative reduction combined with air enema improves outcomes for intussusception in children. This method reduces pain and pressure, while enhancing immune function by increasing T lymphocyte levels and decreasing B lymphocyte levels.
Area of Science:
- Pediatric Surgery
- Immunology
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in children.
- Current treatments like air enema carry risks of pain and injury.
- The impact of manipulative reduction on immune function needs further exploration.
Purpose of the Study:
- To evaluate the efficacy of manipulative reduction combined with air enema in treating pediatric intussusception.
- To assess the effect of this combined approach on intestinal mucosal immune function.
- To compare pain scores and procedural pressure between the combined method and air enema alone.
Main Methods:
- A prospective randomized controlled study involving 60 children with intussusception.
- Experimental group: manipulative reduction plus air enema; Control group: air enema alone.
- Measurement of serum immune cell subsets (CD3+, CD4+, CD8+, CD19+, CD56+) before and after reduction.
Main Results:
- No significant difference in reduction success rates between groups.
- The combined method resulted in significantly lower pain scores and enema pressure.
- Post-reduction, the experimental group showed increased CD3+, CD4+, CD8+ levels and decreased CD19+ levels.
Conclusions:
- Manipulative reduction combined with air enema is a safe and effective treatment for pediatric intussusception.
- This approach alleviates pain and reduces procedural pressure.
- It also mitigates reperfusion injury and protects intestinal mucosal immune function.
Objective:
To explore the effect of manipulative reduction combined with air enema on intestinal mucosal immune function in children with intussusception.
Methods:
This is a prospective randomized controlled study in which 60 children with primary intussusception admitted to Hebei Children's Hospital from October 2018 to October 2019 were selected for this study. They were randomly divided into two groups. The 30 patients in the experimental group underwent manipulative reduction and air enema reduction, and 30 patients in the control group underwent only air enema reduction. Pain scores and pressure during enema were recorded and analyzed. Fasting blood of children in the experimental group were drawn to test the serum T lymphocyte subsets CD3+, CD4+, CD8+ levels, B lymphocyte subsets CD19+ level, and NK cell subsets CD56+ levels before reduction. Among them, fasting blood of 28 children with successful reduction were drawn again in the morning after reduction, and the indicators of each immune cell subgroup before and after reduction were analyzed. Two children with unsuccessful reduction were no longer tested for these indicators.
Results:
Twenty-Eight children in the experimental group had successful reduction, and two children with unsuccessful reduction were changed to open surgery (28/30). Twenty five Children in the control group had successful reduction, and five were changed to open surgery (25/30). There was no significant difference in the success rate of reduction between two groups (p>0.05). Close observation for 12~24h after reduction found that none of the children had signs of peritonitis. The pain score and reduction pressure of the observation group were lower than those of the control group, and the difference was statistically significant (p<0.05). The levels of serum CD3+, CD4+, and CD8+ after reduction in the experimental group were significantly higher than before reduction, and the difference was statistically significant (p<0.05). CD19+ level was significantly lower than before reduction, and the difference was statistically significant (p<0.05). There was no significant difference in changes of other indicators.
Conclusions:
Manipulative reduction combined with air enema reduction can relieve pain and air injection pressure during enema, reduce reperfusion injury caused by intestinal ischemia, and protect intestinal mucosal immune function, which is a favored treatment.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:21Drugs for Treatment of Constipation-Predominant IBS