DSA引导的经减压孔快速交换法置入经鼻型肠梗阻导管

DSA-guided transnasal insertion of intestinal obstruction tube via decompression hole with rapid catheter-wire exchange technique

目的研究快速交换法置入经鼻型肠梗阻导管的可行性和优势。方法29例小肠梗阻患者接受快速交换法置入肠梗阻导管。泥鳅交换导丝到位后,其尾端经肠梗阻导管端孔进入,并经减压侧孔引出,透视下快速交换法置管。临床转归为分为:痊愈、手术、好转、无效。其中,痊愈、好转、手术视为临床有效。以技术成功率和临床有效率评价效果。结果技术成功率100%。临床转归计有痊愈9例、手术5例、好转13例、无效2例。临床有效率93.1%(27/29)。结论DSA引导的经侧孔快速交换法可简捷地置入经鼻型肠梗阻导管,是治疗小肠梗阻的有效方法。

Objective To investigate the feasibility and advantages of rapid catheter-wire exchange technique in DSA-guided transnasal insertion of intestinal obstruction tube via decompression hole.Methods Twenty-nine patients with small bowel obstruction(SBO)received placement of intestinal obstruction tube by using rapid catheter-wire exchange technique.After the loach exchange guide-wire tip was placed in the target site,its tail-end was inserted into the top-hole of intestinal obstruction tube and the guide-wire was pushed forward until it came out through the lateral decompression hole of the tube.Then,under fluoroscopy guidance the intestinal obstruction tube implantation was carried out with rapid catheter-wire exchange technique.The clinical outcomes of patients included clinical cure,receiving surgery,clinical improvement,and invalid.The clinical cure,receiving surgery and clinical improvement were regarded as clinical effective outcomes.The technical success rate and clinical effective rate were used to evaluate the therapeutic efficacy.Results The technical success rate was 100%.Clinical outcomes included cure(n=9),receiving surgery(n=5),clinical improvement(n=13)and invalid(n=2).The clinical effective rate was 93.1%(27/29).Conclusion Under DSA guidance rapid catheter-wire exchange technique via lateral decompression hole of tube can easily and quickly accomplish transnasal insertion of intestinal obstruction tube.Therefore,it is an effective therapeutic method for SBO.