以胃管代替肛管在溃疡性结肠炎保留灌肠中的应用

Application of gastric tube as substitute for anal tube in retention enema for ulcerative colonitis

目的探索治疗溃疡性结肠炎中行保留灌肠的新方法。方法选取2014年1月至2015年4月份入住我院消化内科二区确诊为急性发作溃疡性结肠炎,病变部位在乙状结肠、降结肠、升结肠,均需采取保留灌肠治疗的患者63例,其中将2014年1~10月收治的31例患者设为对照组,2014年11月至2015年4月收治的32例患者设为观察组,对照组采用传统的肛管灌肠(肛管组),观察组使用14#胃管代替肛管灌肠(胃管组),观察两组患者在保留灌肠时的肛区疼痛反应,记录插管次数,统计一次性插管成功率和给药后溃疡性结肠炎急性发作缓解症状情况。结果胃管组一次性插管成功率为93.75%(30/32),肛管组为67.74%(21/31);插管时肛区疼痛不适发生率方面,胃管组为6.25%(2/32),肛管组为35.48%(11/31);从控制急性发作缓解症状的给药效果来看,胃管组的缓解率为96.88%(31/32),肛管组为70.97%(22/31),以上各项指标比较差异均有统计学意义(P<0.05)。结论保留灌肠可以使用胃管代替常规肛管,此方法给药效果更好,患者更易接受,临床护士更容易掌握操作技术要领。

Objective To explore a new approach of retention enema in treating ulcerative colonitis.Methods Sixty-three patients with ulcerative colonitis requiring retention enema in our hospital from Jan. 2014 to Apr. 2015 were enrolled in the study, with lesion located in sigmoid colon, descending colon, ascending colon. The patients were divided into two groups according to the sequential order of admission: the observation group(32 patients,from Jan. 2014 to Oct. 2017) and the control group(31 patients, from Nov. 2014 to Apr. 2015). The control group received conventional enema through anal tube(anal tube group), and the observation group received slow insertion of 14#gastric tube as substitute(gastric tube group). The pain response in anal region, times of intubation, the one-time success rate of intubation, and the relieving situation of acute attack of ulcerative colitis after administration were observed and recorded. Results The one-time success rate of intubation was 93.75%(30/32) in the observation group and 67.74%(21/31) in the control group. The incidence of anal pain during insertion was 6.25%(2/32) in the observation group and35.48%(11/31) in the control group, indicating better patient acceptance in the observation group. In terms of the treatment effect for reliving the symptoms, the treatment gave relief in 96.88%(31/32) of the patients in the observation group as compared to 70.97%(22/31) patients in the control group. The differences were all statistically significant(P<0.05). Conclusion Gastric tube can be used as a substitute for conventional anal tube in retention enema for ulcerative colonitis, as it provides better treatment effect, is more acceptable among patients, and is more convenient for operation.