经鼻插入型肠梗阻导管治疗粘连性小肠梗阻的临床应用

摘要

Objective To investigate the clinical application of nasal-insertion type ileus-tube in the treatment of adhesive small intestinal obstruction. Methods A total of 221 patients with simple adhesive small intestinal obstruction, who were admitted to authors’ hospital during the period from January 2010 to Aug. 2014, were enrolled in this study. The patients were randomly divided into nasal-insertion type ileus-tube group (n=111) and nasogastric tube group (n=110). After the procedure, the patients were kept under close observation, focusing on the abdominal distention, gastrointestinal decompression amount, the recovery time of anal exhaustion and defecation, the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film, etc. The cure rate, effective rate and transit-operation rate were calculated. The results were compared between the two groups. Results The tube placement operation was successfully performed in all patients. Compared with the nasogastric tube group, in the nasal-insertion type ileus-tube group the recovery time of abdominal distention, anal exhaustion and defecation and the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film were obviously shorter, and the gastrointestinal decompression amount was larger. In the nasal-insertion type ileus-tube group the cure rate and effective rate were significantly increased, while the transit-operation rate was decreased; the differences between the two groups were statistically significant (P<0.05). Conclusion For the treatment of adhesive small intestinal obstruction, the placement of nasal-insertion type ileus-tube is effective and reliable. This technique can strikingly improve the clinical symptoms, therefore, it is worthy of promotion and application in clinical practice.%目的：评估经鼻型肠梗阻导管治疗粘连性小肠梗阻的临床疗效。方法2012年1月—2014年8月221例入院诊断为单纯粘连性小肠梗阻的患者随机行经鼻肠梗阻导管（n=111）、鼻胃管（n=110）减压治疗。观察两组患者腹胀腹痛改善情况、胃肠减压量、肛门排气排便恢复时间、腹部立卧位X线平片示气液平面消失时间，治愈率、有效率及中转手术率等指标。结果所有患者均按要求置管成功。与鼻胃管相比，经鼻插入型肠梗阻导管组患者腹胀腹痛等腹部症状缓解时间、肛门排气排便恢复时间、气液平面消失时间均明显缩短，胃肠减压引流量显著增加。可提高患者治愈率、有效率并降低中转手术率，差异均有统计学意义（P<0.05）。结论经鼻肠梗阻导管置入术治疗粘连性小肠梗阻疗效确切，能够显著改善患者的临床症状，值得在临床中推广应用。