肠内全程导管减压法用于术后早期炎性肠梗阻治疗的研究

Ileus tube in the treatment of early postoperative inflammatory small bowel obstruction:a study of 8 cases

目的评价经鼻置入导管行肠内全程减压在术后早期炎症性肠梗阻保守治疗中的作用。方法回顾性分析北京大学第三医院2005年3—8月收治的8例腹部手术后早期炎症性肠梗阻的病人，使用鼻胃管减压等常规保守治疗无效后，经鼻置入导管行肠内全程减压，并进行胃肠减压治疗，观察其治疗效果。结果与鼻胃管相比，使用肠内全程导管减压后，病人的胃肠减压量明显增加、腹围和腹腔内压力明显降低；通过3～10d的经鼻置入导管减压等保守治疗后，8例病人的肠梗阻症状均缓解，未再接受手术治疗。结论经鼻肠内全程导管减压用于治疗术后早期肠梗阻安全有效，且可能使病人免于再次急诊手术。

Objective To evaluate the role of via-nasal ileus tube in the conservative treatment of early postoperative inflammatory small bowel obstruction （EPISBO）. Methods The data of eight casas of EPISBO admitted between March 2005 and August 2005 in Peking University Third Hospital were reviewed retrospectively, All patients failed to improve with nasogastric tube decompression, and then via-nasal ileus tube decompression was recommended. The curative effects were observed according to some outcome measures. Results With the ileus tube decompression, the volume of gastrointestinal decompression was increased significantly, and the abdominal circumstance and intra-abdominal pressure were decreased significantly compared with the nasogastric tube decompression. After 3 to 10 days of via-nasal ileus tube decompression ,all patients were discharged without complication or emergency re - operation. Conclusion Patients with EPISBO can be managed by via-nasal ileus tube decompression safely and effectively. It is possible for patients to avoid re-operation of laparotomy.