X线下经鼻型肠梗阻导管治疗肠梗阻的临床应用

Fluoroscopically-Guided Transnasal Insertion of Ileus Tube for Intestinal Decompression in Patients with Bowel Obstruction

目的探讨肠梗阻导管治疗肠梗阻的临床效果。方法影像科于2009年6月-2012年5月收治32例急性肠梗阻病人(导管组),在X线透视下置入肠梗阻导管进行治疗,并与32例常规胃肠减压病人(对照组)治疗结果进行比较,分析两组治疗48h后腹痛、腹胀消失及肛门恢复排气率、腹围比值(测量脐水平的腹部周径,以导管置入前腹围为100%计算置管后腹围与置管前腹围的比值)、治愈率的差异。结果导管组48h腹痛、腹胀消失及肛门恢复排气率为84.4%,对照组为50.0%(P<0.05);导管组治疗第1天,腹围比值为(79.3±18.6)%,对照组为(90.1±8.7)%(P<0.05);导管组中治愈28例(87.5%),对照组为21例(65.6%,P<0.05)。结论肠梗阻导管治疗各种类型肠梗阻,操作简单、有效、经济,有临床推广价值。

Objective To assess the effectiveness of fluoroscopically-guided transnasal insertion of ileus tube for intestinal decompression in the treatment of bowel obstruction. Methods 64 cases of patients with acute intestinal obstruction from Jun 2009 through May 2012.32 patients adopted ileus tube for gastrointestinaldecompression, another 32 patients in the control group were treated with traditional nasogastric tubes for decompression. The difference of the time for relieving pain and distension, the reduction degree of abdominal circumference and the curative ratio of the two groups were analyzed. Results In ileus tube group, the time for relieving pain and distension were significantly shorter than that of the control group, P 〈 0.05. The proportion of patients that bowel movement comeback 48 hours later after treatment in ileus tube group was significantly higher than that of control group （84.4% VS 50.0% ）, P 〈 0.05. The reduction degree of abdominal circumference on the first day in the ileus tube group was greatly larger than that of the control group, （90.1 ± 8.7 ） % and （79.3 ± 18.6） % respectively, P 〈 0.01. The curative ratio in the ileus tube group and the control group were 86.7% （28 patients） and 65.6% （21 patients） respectively,P 〈0.05. Conclusion Transnasal ileus tube insertion under fluoroscopic guidance for intestinal decompression was a simple, safe and ecomomical as well as valuable for different types of bowel obstruction.