经鼻导管小肠排列术治疗小儿重症粘连性肠梗阻

Clinical application of pernasal-intubation small intestinal arrangement for adhesive ileus of small infant

目的评价经鼻导管小肠内排列术在治疗小儿外科中粘连性肠梗阻的应用选择和临床疗效。方法回顾性分析2006—2011年26例重症粘连性肠梗阻行经鼻导管内支架肠排列术的临床资料,与同期26行传统内支架排列术作为对照研究。结果所有患儿均有开腹手术病史。26手术均手术成功,均行经鼻导管内支架小肠排列术,23例康复出院,死亡3例,病死率为11.5%。死亡原因,肠瘘1例,爆发性感染1例,心肺衰竭1例。拔管顺利,拔管后仅有轻度呕吐4例,无其他不良反应。23例全部随访2～6 a,无远期梗阻复发。结论经鼻导管内支架小肠排列术是治疗患儿腹腔严重粘连的有效治疗和预防方法,可以选择性应用。

Objective To discuss the clinical experience and curative effect of pernasal intubation small intestinal arrangement for massive adhesive ileus of small infant.Methods From 2006-2011,the data of twenty-six patients with massive adhesive ileus who underwent pernasal intestinal intubation small intestinal arrangement were analyzed retrospectively,The same period26 cases who treated with the conventional opreration as acontrol group.Results All 26 patients had a history of abdominal surgery.26 cases were successfully performed the small intestine plication by nasal catheter,23 patients recovered and were discharged,3 died,the mortality rate is 11.54%.the causes of death including：intestinal fistula in 1 case,the outbreak of infection in 1 case,heart and lung failure in 1 case,the extubation process were successfully and only mild vomiting in 4 cases after extubation,no other adverse reactions.23 patients were followed up for 2-6 all years,no long-term recurrence of obstruction.Conclusion Internal intestinal splinting is an effective management in treating recurrent postoperative massive adhesive ileus,Can beselectivelyapplied.