广泛粘连性小肠梗阻术中经鼻置入肠梗阻导管的临床疗效评价

Evaluation of the clinical efficacy of nasointestinal ileus tube in the operation of extensive adhesive small bowel obstruction

目的分析在广泛粘连性肠梗阻(ABO)术中置入经鼻肠梗阻导管(NIT)的可行性和临床有效性。方法回顾性分析首都医科大学大兴医院普外科于2019年4月—2021年4月之间收治的60例广泛ABO患者的临床及随访资料,其中30例术中行NIT小肠内排列术(观察组),30例同期未行NIT小肠内排列术(对照组)。观察组中男性12例,女性18例;对照组中男性16例,女性14例。比较两组患者手术时间、胃肠功能恢复时间、出院时间、总有效率以及术后并发症发生率,术后24个月肠梗阻复发率计量资料以均数±标准差(±s)表示,组间比较采用t检验;计数资料以例(百分比)[n(%)]表示,组间比较采用χ2检验。结果所有患者均顺利完成手术并顺利出院。对照组和观察组总有效率比较差异无统计学意义(χ^(2)=3.16,P=0.237)。观察组手术时间略长于对照组[(110.6±4.6)min比(94.3±2.5)min,t=17.27,P=0.001];观察组胃肠功能恢复时间与住院时间均短于对照组[(8.13±1.00)d比(8.70±0.70)d,t=2.53,P=0.014;(12.83±1.57)d比(13.67±1.03)d,t=0.03,P=0.018],术后并发症发生率低于对照组(10%比30%,P=0.028),差异有统计学意义。结论术中应用NIT是安全有效的,可明显降低术后肠梗阻的复发率。

Objective To evaluate the feasibility and clinical effectiveness of placing a nasointestinal ileus tube(NTI)during extensive adhesive bowel obstruction(ABO)surgery.Methods A retrospective analysis was performed for the clinical and follow-up data of 60 patients with extensive ABO admitted to the Department of General Surgery of Daxing District Hospital of Capital Medical University from April 2019 to April 2021,of which 30 patients underwent intraoperative NIT intraintestinal alignment(observation group)and 30 patients who did not undergo NIT intraintestinal alignment(control group)during the same period.There were 12 males and 18 females in the observation group.There were 16 males and 14 females in the control group.The operation time,gastrointestinal function recovery time,discharge time,total effective rate and postoperative complication rate were compared between the two groups,and the quantitative data of the recurrence rate of intestinal obstruction at 24 months after surgery were expressed as mean±standard deviation(±s),and the t-test was used for comparison between groups.Numerological data were presented as cases(percentage)[n(%)],and chi-square tests were used for comparison between groups.Results All patients were successfully completed the surgery and discharged from the hospital.There was no statistically significant difference in total effective rate between the control group and the observation group(χ^(2)=3.16,P=0.237).The surgical time in the observation group was slightly longer than that in the control group[(110.6±4.6)min vs(94.3±2.5)min,t=17.27,P=0.001].The recovery time of gastrointestinal function and hospitalization time in the observation group were shorter than those in the control group[(8.13±1.00)d vs(8.70±0.70)d,t=2.53,P=0.014;(12.83±1.57)d vs(13.67±1.03)d,t=0.03,P=0.018].The incidence of postoperative complications was lower than that in the control group(10%vs 30%,P=0.028),and the difference was statistically significant.Conclusion Intraoperative application of NIT is safe and effective,and can significantly reduce the recurrence rate of postoperative intestinal obstruction.