胃镜引导下经鼻肠梗阻减压管置入在小肠梗阻中的应用

Application of nasointestinal decompression intubation assisted by gastroscopy in small bowel obstruction

目的探讨胃镜辅助下鼻肠减压管置入技术在小肠梗阻治疗中的作用。方法回顾分析我院2007年4月～2009年1月收治的13例小肠梗阻患者,在使用常规鼻胃减压管治疗无效后在胃镜辅助下放入鼻肠减压管,并进行胃肠减压治疗,观察置管效果并对疗效进行分析。结果胃镜辅助下鼻肠减压管置入平均时间19.4 min,成功率100%,导管头端到达梗阻上方的平均时间4.3 d,经造影观察均能明确病变部位并对病变性质作出初步判断;置管后病人腹痛、腹胀均有显著缓解,引流量增加,腹围减少;7例患者经减压治疗后小肠梗阻完全缓解,6例需手术治疗患者在手术治疗时均能依据导管头端位置准确定位。结论鼻肠减压管治疗小肠梗阻安全有效,应作为治疗小肠梗阻的首选方法;胃镜辅助置入鼻肠减压管操作简单,成功率高。

Objective To evaluate the effect of nasointestinal decompression intubation assisted by gastroscopy in small bowel obstruction. Methods Thirteen patients with small bowel obstruction treated in our hospital during April 2007 to January 2009 were reviewed. Assisted by gastroseopy nasointestinal decompression intubation were used in these patients after failure treatment with traditional nasal gastric tube decompression. The therapeutic effect of the method was observed. Results The mean time of intestinal decompression tube insertion assisted by gastroscopy was 19.4 minutes and the successful rate was 100%. After average 4.3 days, the top of the tubes arrived at place above the obstruction. With the help of these tubes, we injected contrast agents and made preliminary judgments on the lesions. The abdominal pain, bloating of all of the patients were significantly eased, the drainage quantity increased and abdominal circumfer- ence reduced. Seven patients treated by decompression of small bowel obstruction completely recovered and six patients in surgical treatment were located the lesions based on the head of the tubes. Conclusion Nasointestinal decompression tube is safe and effective treatment of small bowel obstruction, and it should become the preferred method of small bowel obstruction. To place the tube, assisted by gastroscopy is a simple operation with high successful rate.