应用肠梗阻导管治疗术后早期炎性肠梗阻

目的探讨肠梗阻导管在术后早期炎性肠梗阻治疗中的应用价值。方法将2005年6月至2012年6月我院普外科住院病例46例,随机分为2组:A组(应用肠梗阻导管减压组);B组(应用鼻胃管减压组)。均采用常规保守治疗,包括禁食水、纠正水电解质紊乱和酸碱平衡紊乱,全胃肠外营养及应用抗生素。观察比较两组治疗前后临床症状及体征改善情况、胃肠减压量、腹部影像学改变和自主排气、排便时间,对相关数据进行统计学分析。结果本组46例患者均经保守治疗后治愈,A组与B组相比较,腹胀腹痛缓解时间分别为(2.8±1.5)d和(5.2±1.6)d(t=3.191,P=0.004),自主排气排便时间为(6.3±2.8)d和(10.5±3.5)d(t=2.815,P=0.012),CT恢复改变时间(6.8±2.3)d和(9.2±2.9)d(t=5.016,P=0.013),胃肠减压有效率A组与B组相比较P<0.05,差异有统计学意义。结论在常规保守治疗过程中,应用肠梗阻导管能够加速改善术后早期炎性肠梗阻患者梗阻症状,缩短治疗进程,是值得推广的有效治疗方法。

Ileus Tube in the Treatment of Early Postoperative Inflammatory Intestinal Obstruction

Objective To evaluate the application value of ileus tube for early postoperative inflammatory intestinal obstruction.Methods From June 2005-June 2012, 46 Patients diagnosed with early postoperative inflammatory intestinal obstruction were enrolled in the study. Patients were randomly divided into two groups： ileus tube group （group A, n =20 ） and nasogastric tube group （group B, n =26）. All cases received conventional treatment, including fasting, maintaining electrolyte and acid-base balance, parenteral nutrition support and antibiotics. Group A received ileus tube decompression and group B received nasogastrie tube. Results Abdominal pain and abdominal distension recovered faster [（2.8：t：1.5） vs.（5.2＋1.6） d ] in group A compared with group B （t=-3.191, P=-0.004）. Group A had a quick recovery of flatus and stool which compared with group B, [ （6.3±2.8） vs.（10.5±3.5） d] （t=-2.815, P=-0.012）. The disappearing time of liquid and gas in the small bowel was shorter in group A（6.8±2.3）d than in group B（9.2±2.9）d, t=-5.016, P=0.013. The ileus tube had a significant effect on draining digestive juice versus nasogastrie tube, P〈0.05. Conclusions The high improvement rate in abdominal symptoms suggested the efficacy of ileus tube in patients with early postoperative inflammatory intestinal obstruction.