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Abstract
Introduction. Hirschsprung-associated enterocolitis (HAEC) is the most common life-threatening complication of Hirschsprung's disease. The incidence of HAEC ranges from 6-60% before and 25-37% after surgery. Rectal irrigation with warm 0.9% NaCl has been shown to reduce the incidence of HAEC before and after surgery. Rectal irrigation plays a role in preventing faecal stasis by evacuating feces, as well as reducing bacterial colonies in HAEC patients. This study aims to determine the effectiveness of rectal irrigation with warm 0.9% NaCl on the number of intestinal microbiota colonies in Hirschsprung-associated enterocolitis patients at Dr. Mohammad Hoesin Hospital Palembang.
Method: A randomized clinical trial without comparison in the form of an add on trial, open label which is an experiment by providing additional measures to a group with the same standard and different treatment. Patients were divided into three groups, including antibiotics ampicillin, ceftriaxone, metronidazole and 0.9% NaCl irrigation 1 time per 24 hours (Group 1), per 12 hours (Group 2), and per 8 hours (Group 3). Comparisons were tested using paired T-test or Wilcoxon's, p-value <0.05 was considered statistically significant.
Results: HAEC patients who received irrigation treatment 1 time, the number of bacterial colonies did not change, in patients with irrigation treatment 2 times the number of colonies decreased by 171,428.57 ± 138,013.11 colonies/ml, while in patients with irrigation treatment 3 times the number of colonies was reduced. colonies decreased by 214.285.71 ± 177.281.05 colonies/ml. There was a significant difference in the number of bacterial colonies before and after irrigation treatment with a frequency of 2 times (p = 0.026) and 3 times (p = 0.027) while with a frequency of 1 time there was no difference in the number of bacterial colonies before and after treatment (p = 1,000).
Conclusion: Rectal irrigation with warm NaCl 0.9% as much as 20 ml/kg with a frequency of 2 times was effective in reducing the number of gut microbiome colonies. There was no significant difference in the number of bacterial colonies between the 2 and 3 times irrigation frequency groups.
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