Clinical effect of intestinal obstruction catheter on tuberculous peritonitis complicated with intestinal obstruction and its influence on inflammatory factors / 中国综合临床

ABSTRACT

Objective:To explore the clinical effect of intestinal obstruction catheter in patients with tuberculous peritonitis complicated with intestinal obstruction and its influence on inflammatory factors.Methods:Sixty-two patients of tuberculous peritonitis with intestinal obstruction were admitted to the general surgery department of the Eighth Medical Center of Chinese PLA General Hospital from June 2015 to January 2020 in this prospective study.According to the method of digital table, cases were randomly divided into control group and treatment group, 31 cases in each group.The control group was given conventional treatment, while the treatment group was treated with intestinal obstruction catheter on the basis of conventional treatment.The clinical indexes such as abdominal pain relief time, antipyretic time, exhaust time, gas-liquid level disappearance time and hospitalization time were compared between the two groups.According to the levels of C-reactive protein(CRP), Interleukin-6(IL-6), Interleukin-8(IL-8) and Interferon-γ(IFN-γ), the inflammatory stress state of the two groups before and after treatment was compared.The changes of gastrin, motilin, vasoactine intrestinal peptide(VIP) were compared between the two groups before and after treatment.Results:The time to relieve abdominal pain(2.08±1.17) d, the time to reduce fever(3.36±1.89) d, the time to exhaust gas(2.12±1.45) d, the time to disappear gas-liquid level(2.58±1.61) d and the time to stay-in-hospital(9.22±2.13) d in the observation group, and those in the control group were (6.26±2.52), (5.68±2.44), (6.18±2.24), (7.34±2.23), (17.49±3.46) d, respectively.The difference between the two groups was statistically significant( P=0.013, 0.024, 0.035, 0.014 and 0.002, respectively). Before treatment, CRP, IL-6, IL-8, IFN-γ in the control group were (105.62±11.96) mg/L, (657.31±49.67) ng/L, IL-8 (463.53±31.74) ng/L and (47.24±9.66) ng/L , and (106.07±12.03) mg/L, (678.46±51.19) ng/L, (471.68±32.03) ng/L and (46.84±9.28) ng/L in the observation group respectively, and there were no significant differences between the two groups before treatment ( P>0.05). After treatment, CRP, IL-6, IL-8, IFN-γ were (86.25±9.16) mg/L, (373.25±24.18) ng/L, (211.26±20.83) ng/L and (35.42±7.52) ng/L in the control group, and (53.72±7.68) mg/L, (184.27±16.92) ng/L, (82.51±11.35) ng/L and (19.65±3.46) ng/L in the observation group, respectively.After treatment, there were significant differences in the indicators between the two groups ( P=0.021, 0.015, 0.029, 0.011, respectively). There was no difference in the levels of gastrin((180.89±21.17) vs(192.32±21.69) ng/L), motilin((336.73±7.23) vs(357.46±7.29) ng/L) and VIP((102.87±13.49) vs(109.31±13.53)pg/L) between the observation and control group before treatment( P>0.05, respectively). After treatment, the levels of gastrin(65.57±8.72) ng/L, motilin(135.71±14.38) ng/L and VIP(55.07±7.15) pg/L in the observation group were lower than those in the control group((110.35±13.86) ng/L, (231.93±21.95) ng/L, (81.56±10.59) pg/L, respectively), and the differences were statistically significant( P=0.013, 0.021 and 0.014, respectively). Conclusion:Intestinal obstruction catheter can effectively improve the clinical effect, reduce the inflammatory stress response, and promote the recovery of gastrointestinal function in patients with tuberculous peritonitis complicated with intestinal obstruction.