经鼻肠梗阻减压导管置入术治疗老年患者术后粘连性肠梗阻60例分析

Nasointestinal obstruction tube implantation for the treatment of adhesive intestinal obstruction in elderly patients after operation: clinical analysis in 60 cases

目的观察经鼻肠梗阻导管置入术在治疗老年患者术后粘连性肠梗阻中的临床效果。方法选取2011年1月至2014年7月本院收治的120例术后发生粘连性肠梗阻的老年患者为研究对象,将120例患者根据随机数字表法随机分为观察组和对照组各60例。两组患者的一般治疗相同,包括抗感染治疗,禁饮、禁食、肠外静脉营养,纠正水、电解质紊乱和酸碱失衡等。在此基础上,对照组采用传统常规鼻胃管行胃肠减压,观察组行经鼻肠梗阻导管置入术。结果观察组置管后胃肠减压引流量明显高于对照组(P<0.05)。肛门排气排便缓解时间、腹痛腹胀缓解时间及腹部平片缓解时间均显著短于对照组(P<0.05)。观察组患者白细胞恢复时间、血沉恢复时间和C反应蛋白恢复时间均较对照组有明显缩短(P<0.05)。观察组治愈32例,有效23例,总有效率为92%;对照组治愈23例,有效18例,总有效率为68%。组间比较发现,观察组有效率显著高于对照组(P<0.05)。结论经鼻肠梗阻导管置入术治疗老年患者术后粘连性肠梗阻,安全可靠,疗效迅速且显著,避免了再次手术。

Objective To observe the clinical effect of nasointestinal obstruction tube implantation on the treatment of adhesive intes-tinal obstruction in elderly patients after operation. Methods Totally 120 cases of elderly patients suffered from adhesive intestinal obstruction were selected as study objects in our hospital from January 2011 to July 2014. All 120 patients were randomly divided into observation group and control group,with 60 cases in each group. The general treatment of the two groups were the same,including an-ti-inflammatory,ban drink,fasting,parenteral nutrition,correct water,electrolyte disturbance and acid-base imbalance,etc. On the ba-sis,patients in the control group were treated with routine nasogastric tube for gastrointestinal decompression,while patients in the ob-servation group underwent nasointestinal obstruction tube implantation. Results In the observation group after the catheter gastrointes-tinal decompression,drainage volume was significantly higher than the control group（P〈0. 05）,anal exhaust defecation remission time,abdominal pain and distension relieving time and plain film of abdomen remission time were significantly shorter than those in control group（P〈0. 05）. The white blood cell recovery time and recovery time of erythrocyte sedimentation rate of observation group were better than those of control group（P〈0. 05）,while the C reaction protein recovery time had no significant difference between the two groups（P〉0. 05）. In the observation group,32 cases were cured,23 cases were effective,and the total effective rate of the obser-vation group was 92%. While 23 cases were cured,18 cases were effective,the total efficiency was 68%,in control group,which was significantly lower than those of observation group（P〈0. 05）. Conclusion Transnasal ileus tube implantation treatment postopera-tively for elderly patients with adhesive intestinal obstruction,is a safe and reliable approach,which could rapidly and significantly contain curative effect,effectively relieve obstruction intestinal blood circulation,and reduce intestinal toxemia occurrence without reoperation.