肠梗阻导管在单纯复发粘连性肠梗阻治疗中的临床应用

Clinical application of intestinal obstruction catheter in the treatment of simple recurrent adhesive intestinal obstruction

目的评价肠梗阻导管在复发粘连性肠梗阻治疗中的安全性和临床效果。方法收治的复发粘连性肠梗阻患者133例,按照治疗方案不同分为胃管组97例与肠梗阻导管组36例。胃管组患者在入院后给予胃管胃肠减压、抗炎、禁食、灌肠等治疗,导管组通过胃镜下放置肠梗阻导管对梗阻部位进行减压,对比2组患者白细胞下降量、CRP、24 h液体引流量及愈后情况。结果胃管组患者白细胞下降量为(1.3±1.0)×10^(9)/L,CRP下降量为(6.0±2.5)g/L,24 h液体引流量为(509.9±299.1)mL;导管组白细胞下降量为(2.7±2.1)×10^(9)/L,CRP下降量为(10.6±5.3)g/L,24 h液体引流量为(1363.9±466.7)mL,2组比较差异有统计学意义(P<0.05)。导管组平均住院费用为(21876.6±7014.6)元,高于胃管组的(15168.5±11953.4)元(P<0.05);导管组治疗有效率为91.78%,明显高于胃管组的60.82%(P<0.05);导管组治疗后1年内复发率明显低于胃管组(0vs21%)(P<0.05)。结论肠梗阻导管治疗复发粘连性肠梗阻术简单、安全有效,相对单纯胃管治疗能明显提高治疗有效率,降低复发率,具有较高的临床应用价值。

Objective To evaluate the safety and clinical effect of intestinal obstruction catheter in the treatment of recurrent adhesive intestinal obstruction.Methods 133 patients with recurrent adhesive intestinal obstruction were divided into gastric tube group(n=97)and intestinal obstruction catheter group(n=36).The patients in gastric tube group were treated with gastric tube gastrointestinal decompression,anti-inflammatory,fasting and enema.In catheter group:the obstruction site was decompressed by placing an intestinal obstruction catheter under gastroscope.The amount of leukocyte decline,CRP,24-hour fluid drainage and recovery were compared between two groups.Results The decrease of leukocyte(1.3±1.8)×10^(9)/L,CRP(0.6±5.5)g/L and 24-hour liquid drainage(509.9±299.1)ml in the gastric tube group were lower than that of leukocyte(2.7±2.1)×10^(9)/L,CRP(10.6±11.9)g/L and 24-hour liquid drainage(1363.9±466.7)ml in the catheter group(P<0.05);The average cost of hospitalization in the catheter group was(21876.6±7014.6)yuan,which was higher than that in the gastric tube group(15168.5±11953.4)yuan(P<0.05).In the comparison of postoperative indexes between the two groups,it can be seen that the effective rate of catheter group was 91.78%,which was significantly higher than that of gastric tube group(60.8%);The recurrence rate within one year after treatment in the catheter group was significantly lower than that in the gastric tube group(0 vs 21%)(P<0.05).Conclusion The technique of intestinal obstruction catheter in the treatment of recurrent adhesive intestinal obstruction is simple,safe and effective.Compared with simple gastric tube therapy,it can significantly improve the treatment efficiency and reduce the recurrence rate.