双袢法技术在抑制急性胰腺炎空肠营养引发空肠-十二指肠反流中的应用

Technique of double intestinal loop in restraining reflux from jejunum to duodenum,caused by intrajejunal administration of enteral diet of acute pancreatitis

目的评价双袢法技术在抑制急性胰腺炎空肠营养引发空肠-十二指肠反流中的应用价值。方法对182例急性胰腺炎患者行X线下经鼻空肠置管,以营养管在空肠走行的不同长度分3组(10～20 cm为A1组,20～30 cm为A2组,大于30 cm为A3组),同时以营养管在空肠行经的肠袢数分3组(0肠袢为B1组,单肠袢为B2组,双肠袢为B3组),分别比较A分组及B分组内各组间反流情况,再对A分组和B分组中反流率最低的两组进行比较。观察以长度及以肠袢预测空肠-十二指肠反流的能力,总结抑制空肠-十二指肠反流的有效方法。结果以营养管在空肠走行的长度观察,A3组反流率低于A1组及A2组(P<0.012 5);以营养管在空肠走行的肠袢数观察,B3组反流率低于B1组及B2组(P<0.012 5);B3组反流率(6.3%)低于A3组(21.6%)(P<0.05),即双肠袢的B3组反流率在上述6组中最低。结论急性胰腺炎空肠置管达双肠袢,可有效抑制经空肠营养引发的空肠-十二指肠反流。

Objective To evaluate the technique of double intestinal loop in restraining reflux from jejunum to duodenum, caused by intrajejunal administration of enteral diet of acute pancreatitis. Methods A total of 182 patients suffering from acute pancreatitis were placed nasal jejunum catheter guided by X-ray. The 182 patients were divided into three groups according to different length of catheter in jejunum (Al: 10-20 cm, A2: 20-30 cm, A3: more than 30 cm), and divided into three groups according to different quantity of intestinal loop which the catheter went though in jejunum (B1:0 intestinal loop, B2: 1 intestinal loop, B3: 2 intestinal loops). The reflux rates of the different groups were contrasted. Results The reflux rate of A3 was lower than that of A1 and A2 (P<0. 012 5);the reflux rate of B3 was lower than that of B1 and B2 (P<0. 012 5);the reflux rate of B3 was lower than that of B2 (P <C0. 012 5). The reflux rate of B3 was the lowest of the former six groups. Conclusion By placing the catheter into jejunum to two intestinal loops, we can guard against and diminish the reflux from jejunum to duodenum effectively.