胃镜引导下肠减压导管置入在急性麻痹性肠梗阻中的应用

Application of intestinal decompression catheter insertion guided by gastroscope in acute paralytic ileus patients

目的:探讨胃镜引导下肠减压导管置入治疗急性麻痹性肠梗阻的有效性及安全性。方法:选取2014年1月至2016年1月福建医科大学附属第一医院收治的126例急性麻痹性肠梗阻患者为研究对象,随机分为研究组66例,予胃镜引导下肠减压导管置入)和对照组60例,予普通胃肠减压管置入)。比较两组治疗总有效率、置管后平均日引流量、引流天数、总引流量、腹围变化、自主排便排气时间、住院时间、导管梗阻情况。结果:研究组治疗有效率达92.42%,显著优于对照组(61.67%),差异有统计学意义(P<0.05)。研究组置管后平均日引流量、引流天数、总引流量、腹围变化、自主排便排气时间、住院时间均显著优于对照组,差异均有统计学意义(均P<0.05);两组患者导管阻塞率比较,差异无统计学意义(P>0.05)。研究组出现呕吐2例、喉头水肿2例,两组患者均未出现消化道出血病例。结论:应用胃镜引导下肠减压导管治疗急性麻痹性肠梗阻疗效显著,且无严重不良反应发生,值得临床推广使用。

Objective： To evaluate the efficacy and safety of long intestinal tube insertion guided by gastroscope in acute paralytic ileus patients. Methods： 126 patients who underwent intestinal decompression catheter insertion for acute paralytic ileus with the guidance of gastroscope （the research group, n =66） or without gastroscope （the control group, n =60） from January 2014 to January 2016 in our hospital were recruited. The response rate, the volume of drainage, drain duration, abdominal perimeter, evacuation time, hospital days and tube obstruction rate were compared between the two groups. Results： The response rate in the research group was significantly higher than that in the control group （92.42% vs. 61.67%, P 0.05）. The response rate, the volume and duration of drainage, abdominal perimeter, evacuation time and hospital days in the research group were superior to the control group （ P 〈0.05）. There was no statistical significance in the tube obstruction rate between the two groups （ P 〈0.05）. There were 2 cases of vomit and 2 cases of laryngeal edema in the research group, and no alimentary canal hemorrhage was observed in both groups. Conclusion： Gastroscope enabled the high success rate and ensured good safety for the intestinal decompression catheter insertion, and it could be widely used in the treatment of acute paralytic ileus.