DSA引导下经鼻插入型肠梗阻导管治疗良恶性肠梗阻

Application of DSA guided transnasal intestinal tube insertion placement in treatment of malignant form benign lesions intestinal obstruction

目的探讨经鼻插入型肠梗阻导管治疗良、恶性肠梗阻的应用价值。方法采用库利艾特公司生产的经鼻插入型肠梗阻导管,管径为16F/18F,对105例良、恶性肠梗阻患者在DSA引导下进行治疗,观察患者的临床有效率、治愈率、导管引流情况及症状改善时间。结果 105例肠梗阻患者均顺利插入预定部位。随访7～180天(平均94天),临床缓解率与治愈率分别为90.5%(95/105)和29.5%(31/105);并发症有导管堵塞24.8%(26/105)、导管脱落2.86%(3/105)、肠穿孔0.9%(1/105)、肠出血0.9%(1/105),严重并发症发生率为4.76%(5/105),未出现与死亡相关的并发症。结论在DSA引导下经鼻插入型肠梗阻导管引流良、恶性肠梗阻是一种疗效确切、安全可靠、操作易行的介入方法。

Objective To evaluate the clinical application value of patients with malignant form benign lesions intestinal obstruction treated with transnasal intestinal tube insertion. Methods 105 patients with malignant form benign lesions intestinal obstruction were treated with DSA guided transnasal intestinal tube insertion placement. The patients＇ clinical manifestations, cure rate, effective rate, drainage condition and symptoms relieving time were observed and recorded. The transnasal intestinal tube insertion with diameter of 16F/18F is produced by Cliny Company in this study. Results For all 105 patients with intestinal obstruction,the intubation of transnasal intestinal tube insertion into sched- uled position was technically successful. During follow-up of 7～180 days（mean 94days）,The total occurrence of clinical remission rate and cure rate was 90.5% （95/105）and 29.5% （31/105）respectively. The rate of the adverse reactions or complications was 99.0~ （104/105）on uncomfortable pharynx feeling or mildly painful, 24.7 （26/105）on the tube ob- struction, 2.86% （3/105）on the tube removal, 0.9% （1/105）on bowel perforation,0.9 % （1/105）on intestinal bleeding. The total rate of severe complications was 4.76%, and without any complication associated with death. Conclusion Transnasal intestinal tube insertion for decompression guided by DSA in the treatment of malignant form benign lesions intestinal obstruction is safe, effective and reliability of operation.