经鼻型肠梗阻导管在肠梗阻治疗中的临床价值

目的观察经鼻型肠梗阻导管治疗肠梗阻的临床疗效。方法 28例不全性肠梗阻患者经常规治疗无效后安置肠梗阻导管,观察肠梗阻缓解的各项临床指标,即腹胀、腹痛、腹围变化、腹部立卧位平片气液平消失的时间和非手术率的变化。结果 28例患者,肠梗阻完全缓解者21例,时间24~240 h,其中外科手术后所致黏连性肠梗阻16例,克罗恩病1例,肠结核1例,粪石性肠梗阻1例,小肠柿石2例。非手术率75.0%。肠梗阻未能缓解转外科行手术治疗7例,包括结肠肿瘤3例,小肠癌1例,小肠内疝1例,肠道淋巴瘤1例,小肠巨大粪石1例。结论经鼻型肠梗阻导管治疗不全性肠梗阻可明显改善患者临床症状,提高非手术率,为外科手术病变部位定位。

Clinical value of transnasal ileus tube in patients with intestinal obstruction

Objective To observe the clinical effects of transnasal ileus tube in treating with intestinal obstruction. Methods Twenty-eight cases of patients with incomplete intestinal obstruction were selected, set up transnasal ileus tube after ineffective conventional treatment and then observed the clinical indexes reflecting intestinal obstruction remis- sion. These indexes included abdominal distension, abdominal pain, abdominal girth, extinction time of gas-fluid levels of abdomen film on erect and supine positions. Results Twenty-one cases got complete release between 24 and 240 hours. The primary diseases included adhesive ileus caused by surgery （16 cases） , Crohn＇ s disease （1 case） , tuber- culosis （1 case）, fecal obstruction （1 case）, diospyrobezoar disease （2 cases）. The non-surgical rate was 75.0%. Seven cases were sent to surgical treatment after treatment failure by transnasal ileus tube. These included 3 cases of co- lon tumor, 1 case of small intestine cancer, 1 case of small intestine entocele, 1 case of intestinal lymphoma and 1 case of huge bezoar in small intestine. Conclusion Treatment of incomplete intestinal obstruction by transnasal ileus tube can not only obviously improve clinical effects of patients, increase non-surgical rate, but also assist positioning sites of disease for possible surgical treatment.