经DSA引导下置入小肠减压管治疗外科术后小肠梗阻的临床疗效

Postoperative Small Bowel Obstruction treatment by using a Long Intestinal Tube under DSA Guidance

目的对比分析经DSA引导下置入小肠减压管在治疗外科术后小肠梗阻的效果。方法选取我院2015年7月—2016年9月收治的36例普外科术后不完全性小肠梗阻患者,将其分为观察组和对照组,各18例。观察组患者在DSA引导下置管,经72 h后观察梗阻缓解情况,对比减压效果及保守治疗有效率。结果观察组病人均在DSA下置管成功,置管24h及72h之后观察管组每天平均减压引流量相对于对照组明显多,二者有显著差距(P<0.05),观察组拔管时间较对照组也明显缩短,二者有统计学差异(P<0.05)。结论经DSA引导下放置小肠减压管相对于传统鼻胃管减压作用更加突出,能够有缩短梗阻解除的时间。

Objective The aim of this study was to evaluate the effect of the long intestinal tube under DSA （ Digital Subtraction Angiography） guidance on the postoperative small bowel obstruction. Methods Retrospective chart review was conducted of 36 patients with postoperative small bowel obstruction between July 2015 and September 2016. Thirty - six pa- tients were randomly divided into two groups： an observation group （ 18 cases） and a control group （ 18 cases）. Data and im- ages were obtained from patient charts. The insertion of the intestinal tube was guided by DSA. The investigation was per- formed under the treatment for 72 hours comparing nasogastric suction （ short tube） with long tube decompression. Results In the observation group, the long tubes were successfully passed into the jejunum on initial insertion. The mean volume of drainage after 24 h and 72 h intubations were 1173.3 -＋ 722.6ml and 2338.3 ＋ 1296.7ml, respectively, and with a significant difference （ P 〈 0.05 ）. The duration time of the intubation for the observation group was 6. 4 _＋ 5.6 days compared with 10. 4 ~ 2.4 days for the control group （ P 〈 0. 05 ）. Conclusion Long tube treated patients had a high volume of drainage and an effective improvement of decompression of the intestines. So, for patients with postoperative small bowel obstruction, a trial with long tube decompression for 24 to 72 hours is recommended.