经肛肠梗阻导管在结肠癌性肠梗阻治疗中的应用效果及护理措施

The Efficacy of Transanal Ileus Tube in the Treatment of Colonic Carcinomatous Intestinal Obstruction,and Nursing Measures Over Its Application

目的:探讨经肛肠梗阻导管在结肠癌性肠梗阻治疗中的应用效果,并总结护理措施。方法:选择2019年1月至2020年9月于我院肠胃外科就诊的50例结肠癌性肠梗阻患者为研究对象,患者均经肛置入肠梗阻导管治疗,并且置管前接受胃肠减压及心理护理,置管后接受导管安全管理、冲洗护理、饮食指导、会阴皮肤护理等。统计患者置管后肠梗阻缓解时间、置管前后相关临床指标的变化,以及手术情况。结果:患者均成功经肛放置肠梗阻导管,置管后24~48h症状缓解28例,48~72h症状缓解21例,72h以后缓解1例。置管后第3天患者腰围、腹内压、近端肠管最大横径、减压导管引流量均明显小于置管前,P<0.05或P<0.001。本组48例患者接受Ⅰ期根治性手术,2例患者因肿瘤转移接受姑息性手术并永久性造口。结论:经肛肠梗阻导管用于结肠癌性肠梗阻治疗安全有效,可快速解除梗阻症状,为Ⅰ期手术创造条件。

Objective To investigate the efficacy of transanal ileus tube in the treatment of colonic carcinomatous intestinal obstruction(CCIO),and nursing measures over its application.Methods Enrolled 50CCIO patients treated in author’s hospital(2019-01-2020-09)in this study:they all received transanal ileus tube treatment,before placement of catheter received gastrointestinal decompression and mental nursing,after placement of catheter also received safe management of catheter,irrigation nursing,diet introduction,and the nursing on perineum skin,etc.;the satus on surgery and the change of relevant clinical norms before and after placement of catheter,as well as the remission time of intestinal obstruction following placement of catheter were recorded statistically.Results In the patients catheter was successfully paced,afterward 24-48hlate 28cases’symptoms were relieved,48-72h21relieved,>72h1relieved;on the 3rd day after placement of catheter,the patients’above-mentioned relevant clinical norms(waist circumference,intra-abdominal pressure,maximum transverse diameter of proximal bowel drainage volume of decompression tube)were significantly smaller than those before placement of catheter(P<0.05,or,P<0.001);in the 50cases,48receivedⅠstage radical procedure,rest 2received palliative surgery with permanent stoma.Conclusion Transanal ileus tube in the treatment of CCIO is safe and effective,can fastly remove symptoms of intestinal obstruction,so that create conditions for performingⅠstage surgery.