经鼻肠梗阻导管与经鼻胃管治疗结直肠癌术后早期低位小肠梗阻的疗效分析

The efficacy of nasointestinal tube versus nasogastric tube in the treatment of early distal small bowel obstruction after colorectal cancer surgery

目的比较经鼻肠梗阻导管与经鼻胃管治疗结直肠癌术后早期低位小肠梗阻的临床疗效。方法依据随机数字表法将160例结直肠癌术后早期低位小肠梗阻患者分为研究组和对照组,每组80例,研究组患者进行经鼻肠梗阻导管治疗,对照组患者进行经鼻胃管治疗,比较两组患者置管48h后的减压效果(腹腔内压力降低程度、腹围减小程度和日平均引流量)、总有效率及不良反应发生情况。结果置管48h后,研究组患者的腹腔内压力降低程度、腹围减小程度均明显高于对照组,日平均引流量明显多于对照组,差异均有统计学意义(P﹤0.01);研究组患者的总有效率为88.75%,高于对照组的73.75%,差异有统计学意义(P﹤0.05)。两组患者腹胀、腹痛的发生率比较,差异均无统计学意义(P﹥0.05);研究组患者呕吐的发生率明显低于对照组,差异有统计学意义(P﹤0.01)。研究组患者的不良反应总发生率为32.50%,明显低于对照组的68.75%,差异有统计学意义(P﹤0.01)。结论采用经鼻肠梗阻导管治疗结直肠癌术后早期低位小肠梗阻具有较好的临床疗效,且可降低不良反应发生率,值得进一步推广。

Objective To investigate the effect of nasointestinal tube and nasogastric tube in the treatment of early distal small bowel obstruction(SBO)after colorectal cancer surgery.Method A total of 160 patients with early distal SBO after operation for colorectal cancer were included and randomized as study group and control group,with 80 cases in each.The study group was treated with nasointestinal tube,while the control group was given nasogastric tube for SBO,the decompression effect after 48 h of tube placement(decrease of intra-abdominal pressure,abdominal circumference,and daily average drainage volume),overall response rate and adverse reactions between the two groups were compared.Result Forty-eight hours after catheterization,the reduction of intra-abdominal pressure and abdominal circumference were significantly higher in study group than those in control group,and the average daily drainage volume was more compared to control group,with statistically significant differences noted(P<0.01);the overall response rate in the study group was 88.75%,which was significantly higher than that in the control group at 73.75%,the difference was of statistical significance(P<0.05);the incidence of abdominal distension and abdominal pain were similar between the two groups(P>0.05);while significantly lower incidence of vomiting was noted in study group compared to control group(P<0.01).The overall incidence of adverse reactions in the study group(32.50%)was evidently lower than that in the control group(68.75%)(P<0.01).Conclusion The use of nasointestinal tube in the treatment of early distal SBO after colorectal cancer surgery is rather effective,with lower incidence of adverse reactions.